Pulmonology Coding Alert

Question: I'm not sure I know what a pleural effusion is. How does the physician treat it?

North Carolina Subscriber

Answer: A pleural effusion, or an abnormal fluid accumulation between the pleural surfaces, can be caused by lung cancer, pneumonia, lung infections, drug reactions, asbestosis, sarcoidosis, abnormal lung pressure and congestive heart failure.

Treatment options: The physician may treat the condition using one of the following methods:

Thoracentesis ( 32421, Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent; and 32422, Thoracentesis with insertion of tube with or without water seal [e.g., for pneumothorax] [separate procedure]); or Chest tube insertion (32551, Tube thoracostomy with or without water seal [e.g., for abscess, hemothorax, empyema] [separate procedure]).

Diagnosis: You'll report ICD-9 code 511.x (Pleurisy) for most patients with a pleural effusion.

Clinical and coding expertise for this issue are provided by Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania Department of Medicine in Philadelphia.