Pulmonology Coding Alert

Question: Can physician bill 76942-59 with 32555 when done in hospital or is it bundled with the code?

Minnesota Subscriber

Answer: There were two new codes introduced to report a thoracentesis procedure performed by your pulmonologist. If your pulmonologist performs the thoracentesis without the aid of any imaging guidance, you will have to use 32554 (Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance). If your pulmonologist uses imaging guidance during the procedure, you will have to use 32555 (Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance).

If you look at the descriptor for 32555, it very clearly states that any imaging guidance is included into 32555 and should not be reported separately. Also, you should remember that you cannot use 32554 and report the imaging guidance as a separate procedure using 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation)with the modifier like how you have done in your question.

So, you will only have to report 32555 for the procedure that your pulmonologist performed and will not bill out the ultrasound imaging guidance with a separate code.