Radiology Coding Alert

The AMA includes a thoracentesis code overhaul in CPT 2008. Check out this breakdown of the new chest tube codes:

• Deleted: 32000 -- Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent

• Added: 32421 -- Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent

• Impact: Code 32421 is identical to code 32000. Just be sure to report 32421 instead of 32000 starting in January.

• Deleted: 32002 -- Thoracentesis with insertion of tube with or without water seal (e.g., for pneumothorax) (separate procedure)

• Added: 32422 -- Thoracentesis with insertion of tube, includes water seal (e.g., for pneumothorax), when performed (separate procedure)

• Impact: Code 32422 is nearly identical to code 32002 and includes a water seal, if used. Just be sure to report 32422 instead of 32002 starting in January. The language change -- from "with or without water seal" to "includes water seal" -- makes for more accurate coding, says Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.

• Deleted: 32005 -- Chemical pleurodesis (e.g., for recurrent or persistent pneumothorax)

• Added: 32560 -- Chemical pleurodesis (e.g., for recurrent or persistent pneumothorax)

• Impact: Code 32560 is identical to code 32005. Report 32560 instead of 32005 starting in January.

• Deleted: 32019 -- Insertion of indwelling tunneled pleural catheter with cuff

• Added: 32550 -- Insertion of indwelling tunneled pleural catheter with cuff

• Impact: Code 32550 is identical to code 32019. Report 32550 instead of 32019 starting in January.

• Deleted: 32020 -- Tube thoracostomy with or without water seal (e.g., for abscess, hemothorax, empyema) (separate procedure)

• Added: 32551 -- Tube thoracostomy, includes water seal (e.g., for abscess, hemothorax, empyema), when performed (separate procedure)

• Impact: Code 32551 includes water seal. But this change mostly tightens up coding for the procedure because a water seal is almost always used during a chest tube insertion, says Alan L. Plummer, MD, at Emory University School of Medicine in Atlanta.