CPT CODES

CPT Code 32200

CPT code 32200 is used to describe the procedure of draining an open lung lesion, providing a standardized way to document this medical service.

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What is CPT Code 32200

CPT code 32200 is a medical billing code used to describe the procedure of draining an open lung lesion. This involves a surgical intervention where a healthcare provider creates an opening to access and drain a lesion, such as an abscess or infected area, within the lung. This procedure is typically performed to relieve symptoms, prevent further infection, and promote healing by removing accumulated fluid or pus from the affected lung tissue. The use of this specific CPT code ensures accurate documentation and billing for the services provided during this surgical procedure.

Does CPT 32200 Need a Modifier?

For CPT code 32200, "Drain open lung lesion," the following modifiers may be applicable depending on the specific circumstances of the procedure:

1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.

2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both lungs during the same session, this modifier indicates that the procedure was performed bilaterally.

3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.

4. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.

5. Modifier 53 - Discontinued Procedure: If the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier is appropriate.

6. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

7. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier is used to indicate the repeat service.

8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different physician.

9. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This is used when a related procedure is performed during the postoperative period of the initial procedure.

10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.

11. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier is used to indicate their involvement.

12. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.

13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.

14. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate the use of multiple modifiers.

Each modifier should be used in accordance with the specific circumstances of the procedure and the payer's guidelines. Proper documentation is essential to support the use of any modifier.

CPT Code 32200 Medicare Reimbursement

The CPT code 32200 is subject to reimbursement by Medicare, but its reimbursement status depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your region.

The MPFS provides a list of services covered by Medicare and assigns a relative value to each service, which influences reimbursement rates. However, local coverage determinations (LCDs) made by MACs can affect whether a particular service is reimbursed in a specific area.

Therefore, it is essential to verify with your regional MAC to confirm the reimbursement status of CPT code 32200 under Medicare.

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