Wiki Pigtail Catheter Placement for Spontaneous Pneumothorax

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elizabeth24

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ER physician inserted a pigtail catheter at 4th intercostal space and was sutured in place secondary to spontaneous pneumothorax. Is this going to be 32550 or 32554 or am I totally off base? Proper placement was confirmed by imaging report.
Thanks in advance!!
 
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We have to look at several things when coding such a procedure: the approach whether it is open(making incision on the chestwall) or percutaneous(small puncture on the chest wall), whether the tube is left in place or not, and whether imaging guidance is used. So, if the approach was percutaneous then it should be 32557. Hope this helps.
 
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wisibyusha said:
We have to look at several things when coding such a procedure: the approach whether it is open(making incision on the chestwall) or percutaneous(small puncture on the chest wall), whether the tube is left in place or not, and whether imaging guidance is used. So, if the approach was percutaneous then it should be 32557. Hope this helps.
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Pigtail was placed left 4th intercostal space, catheter was sutured in place, placement confirmed by xray....does that help?
 
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elizabeth24 said:
ER physician inserted a pigtail catheter at 4th intercostal space and was sutured in place secondary to spontaneous pneumothorax. Is this going to be 32550 or 32554 or am I totally off base? Proper placement was confirmed by imaging report.
Thanks in advance!!
Click to expand...
A pigtail catheter is a small bore catheter that is either inserted for drainage and removed (32554, 32555) or as you indicate, sutured in place to remain after the procedure (32556, 32557). Code 32550 is an open procedure (thoracostomy) rather than percutaneous and involves a different and larger catheter. As you note that placement was confirmed by xray, it sounds like this took place after the procedure (imaging guidance not used during the procedure). If that is correct, code 32556 is more appropriate than 32557. I hope that helps.
 
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Cynthia Hughes said:
A pigtail catheter is a small bore catheter that is either inserted for drainage and removed (32554, 32555) or as you indicate, sutured in place to remain after the procedure (32556, 32557). Code 32550 is an open procedure (thoracostomy) rather than percutaneous and involves a different and larger catheter. As you note that placement was confirmed by xray, it sounds like this took place after the procedure (imaging guidance not used during the procedure). If that is correct, code 32556 is more appropriate than 32557. I hope that helps.
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yes, the imaging guidance was only used to confirm placement, not during the procedure.
Thank you!! That helps a lot :)
 
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