cpt code and Descripiton
** 32421 – Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent (Identical to code 32000)
** 32422 – Thoracentesis with insertion of tube, includes water seal (e.g., for pneumothorax) (separate procedure) (Nearly identical to code 32002; 32422 specifies the inclusion of a water seal)
** 32560 – Chemical pleurodesis (e.g., for recurrent or persistent pneumothorax) (Identical to code 32005)
** 32550 – Insertion of indwelling tunneled pleural catheter with cuff (Identical to code 32019)
** 32551 – Tube thoracostomy, includes water seal (e.g., for abscess hemothorax, empyema) when performed (separate procedure) (Nearly identical to code 32020; 32551 specifies the inclusion of a water seal)
A tube thoracostomy (CPT code 32551) may be performed for drainage of an abscess, empyema, or hemothorax. The code descriptor for CPT code 32551 defines it as a “separate procedure”. It is not separately reportable when performed at the same patient encounter as another open procedure of the thorax unless it is performed in the thoracic cavity contralateral to the one entered to perform the open thoracic procedure.
A chest tube insertion procedure (e.g., CPT codes 32550, 32551, 32554, 32555) is often followed by a chest radiologic examination to confirm the proper location and positioning of the chest tube. A chest radiologic examination CPT code (e.g., 71010, 71020) should not be reported separately for this radiologic examination.
Example 11: Column 1 Code / Column 2 Code – 32551/71020 >CPT Code 32551 – Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure) >CPT Code 71020 – Radiologic examination, chest, 2 views, frontal and lateral; Modifier 59 may be reported if, later in the day following the insertion of a chest tube, the patient develops a high fever and a chest x-ray is performed to rule out pneumonia. CPT code 71020 should not be reported and modifier 59 should not be used for a chest x-ray that is performed following insertion of a chest tube in order to verify correct placement of the tube.
Modifier 59 is used appropriately for a diagnostic procedure which occurs subsequent to a completed therapeutic procedure only when the diagnostic procedure is not a common, expected, or necessary follow-up to the therapeutic procedure.
Pulmonary Codes Fee Schedule – FL
| CPT Code | Description | Mod | POS | Medicare Allowed Amount for Office | Medicare Allowed Amount for Hospital |
| 10021 | FNA W/O IMAGE | – | Office | 133.47 | 71.87 |
| 31500 | INTUBATION | – | Hospital | – | 115.17 |
| 31510 | LARYNGOSCOPY WITH BIOPSY | – | Hospital | 198.33 | 121.69 |
| 31622 | BRONCH DIAG WITH AND W O BRUSH | – | Hospital | 298.88 | 150.5 |
| 31623 | BRONCH WITH BRUSHING OR PROTECTED BRUSHING | – | Hospital | 321.16 | 149.67 |
| 31624 | BRONCH WITH LAVAGE | – | Hospital | 300.16 | 150.37 |
| 31625 | BRONCH WITH BIOPSY ENDOSCOPIC | – | Hospital | 324.86 | 174.73 |
| 31628 | BRONCH WITH FLUROSCOPY | – | Hospital | 382.81 | 193.13 |
| 31629 | BRONCH WITH TRANSBORON NEEDLE ASP W ANGIO | 51 | Hospital | 580.97 | 208.61 |
| 31635 | BRONCH WITH REMOVAL OF FOREIGN BODY | 51 | Hospital | 316.35 | 194.89 |
| 31645 | BRONCH WITH THERAPEUTIC ASP OF TRACH INITIAL | – | Hospital | 219.56 | 164.17 |
| 31646 | BRONCH WITH ASPIRATION TRACH TREE | – | Hospital | 264.29 | 142.5 |
| 32421 | THORA PUNTCURE OF PLURAL CAVITY | 59 | Hospital | 149.97 | 79.28 |
| 32422 | THORACENTESIS WITH TUBE INSERTION | – | Hospital | 191.86 | 126.76 |
| 32551 | TUBE THORACOSTOMY WITH OR W O WATER SEAL | – | Hospital | 182.23 | – |
| 32560 | CHEMICAL PLEURODESIS | – | Hospital | 250.33 | 89.7 |
| 36556 | CENTRAL LINE PLACEMENT | – | Hospital | 227.69 | 127.25 |
| 36620 | ARTERIAL CATH | – | Hospital | 52.14 | – |
| 36680 | INSERT NEEDLE, BONE CAVITY | – | Hospital | 64.45 | – |
| 36800 | INSERTION OF CANNULA | – | Hospital | 165.4 | – |
| 42802 | BIOPSY OF THROAT | – | Hospital | 219.9 | 132.06 |
| 43752 | NASOGASTRIC TUBE PLACEMENT | – | Hospital | 42.76 | – |
| 86580 | PPD test | – | Office | 6.92 | – |
| 90471 | Vaccine Administration | – | Office | 21.1 | – |
| 90472 | IMMUNIZATION ADMIN | – | Office | 10.93 | 8.13 |
| 92950 | CPR | – | Hospital | 272.21 | 180.52 |
| 93010 | EKG INTERPERATION | – | Hospital | 9.21 | – |
| 94010 | SPIROMETRY | – | Office | 32.23 | 8.51 |
| 94010 | SPIROMETRY | Hospital | 32.23 | – | |
| 94010 | SPIROMETRY | 26 | Hospital | 8.51 | – |
| 94060 | BRONCHOSPASM PRE & POST | – | Office | 55.82 | – |
| 94060 | BRONCHOSPASM PRE & POST | 26 | Office | – | 14.96 |
| 94240 | LUNG VOLUME | – | Office | 37.22 | – |
| 94240 | LUNG VOLUME | 26 | Office | – | 12.45 |
| 94350 | LUNG NITROGEN WASHOUT CURVE | – | Office | 33.02 | – |
| 94350 | LUNG NITROGEN WASHOUT CURVE | – | Office | – | 12.45 |
| 94370 | BREATH AIRWAY CLOSING VOLUME | – | Office | 32.32 | – |
| 94370 | BREATH AIRWAY CLOSING VOLUME | – | Office | – | 12.45 |
| 94664 | Inhaler demonstration and/or evaluation of patient utilization | – | Office | 13.92 | – |
| 94720 | MONOXIDE DIFFUSING CAPACITY | – | Office | 48.42 | – |
| 94720 | MONOXIDE DIFFUSING CAPACITY | 26 | Office | – | 12.45 |
| 94760 | Oximetry | – | Office | 2.72 | – |
| 94761 | Oximetry multiple | – | Office | 4.12 | – |
| 95805 | MULTIPLE SLEEP LATENCY TEST | – | Hospital | 378.68 | – |
| 95805 | MULTIPLE SLEEP LATENCY TEST | 26 | Hospital | 91.24 | – |
| 95810 | BASELINE SLEEP STUDY | – | Hospital | 735.94 | – |
| 95810 | BASELINE SLEEP STUDY | 26 | Hospital | 169.62 | – |
| 95811 | CPAP SLEEP STUDY | – | Hospital | 812.64 | – |
| 95811 | CPAP SLEEP STUDY | 26 | Hospital | 183.4 | – |
| 96372 | Injection administration | – | Office | 21.1 | –
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