Pulmonology Coding Alert

Question: I code for a hospital outpatient facility. A pulmonologist brought a patient into radiology to perform paracentesis on the patient’s pleural cavity using the radiology department’s ultrasound guidance. The radiologist read the image but didn’t assist with the procedure.

How do I report the procedure?

Connecticut Subscriber

Answer: You’ll report the procedure with 32555 (Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance). The pulmonologist performed the paracentesis and the radiologist performed the imaging, but there is no way to indicate this in your claim with modifiers or by reporting the component services (32554 and 76942). Instead, this situation needs to be brought to the attention of the practice administrators. Most likely, they are not aware of the billing implications. The way that most practices handle this scenario is through a lease agreement. The pulmonary practice leases the radiology services for these procedures. This allows the pulmonary practice to bill for the complete service, 32555.