Pulmonology Coding Alert

Question: The pulmonologist visits with a patient with malignant cancer of the main bronchus who is suffering from a probable malignant pleural effusion. The physician performs a thoracentesis with insertion of tube. What codes should I use on the claim?Indiana SubscriberAnswer: Report the following for this encounter:32422 (Thoracentesis with insertion of tube, includes water seal [eg, for pneumothorax], when performed [separate procedure]) for the thoracentesis162.2 (Malignant neoplasm of trachea, bronchus and lung; main bronchus) to represent the underlying cancerous condition511.81 (Malignant pleural effusion) to represent the malignant effusion. You must wait for the final diagnosis from cytology on the pleural fluid before you code it.Remember: You should use 511.81 when the pleural fluid is cancerous. Experts describe a malignant pleural effusion as a condition caused by a cancerous invasion of the pleura -- either due to cancer within the lung or metastatic disease from any other organ. Make sure you code [...]