© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 32035 involves a thoracostomy with rib resection specifically performed to address empyema, which is an accumulation of pus in the pleural space. In this surgical intervention, the physician makes a small incision in the chest wall, strategically located over the rib that is situated above the area of the empyema collection. The primary goal of this procedure is to create an opening in the chest cavity that facilitates the drainage of the abscess. To achieve this, a segment of the rib is excised, allowing access to the pleural space. Once the pleural cavity is entered, the physician meticulously breaks down any loculated cavities within the pleural space, which may involve the use of a fingertip or suction tip to ensure thorough drainage. Following the aspiration of the empyema collection, the pleural space is irrigated with an antibiotic solution to help prevent infection. To maintain continuous drainage, a large bore chest tube is inserted into the empyema pocket through a separate incision. This procedure is critical for managing empyema effectively, as it not only alleviates the accumulation of pus but also promotes healing and recovery in the affected area.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 32035 is indicated for the treatment of empyema, which is characterized by the presence of pus in the pleural space. This condition may arise due to various underlying causes, including pneumonia, lung abscess, or post-surgical complications. The following are specific indications for performing this procedure:
The procedure for CPT® Code 32035 involves several critical steps to ensure effective drainage of the empyema. Each step is outlined as follows:
After the completion of the thoracostomy with rib resection, the patient will require careful monitoring and post-procedure care. The placement of the chest tube allows for ongoing drainage of any remaining fluid in the pleural space, and it is essential to ensure that the tube remains patent. Patients may experience some discomfort at the incision site, which can be managed with appropriate analgesics. Follow-up imaging may be necessary to assess the effectiveness of the drainage and to monitor for any potential complications, such as re-accumulation of fluid or infection. The healthcare team will provide instructions regarding activity restrictions and signs of complications that should prompt immediate medical attention.
| Short Descr | THORACOSTOMY W/RIB RESECTION | Medium Descr | THORACOSTOMY W/RIB RESECTION EMPYEMA | Long Descr | Thoracostomy; with rib resection for empyema | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 39 - Incision of pleura, thoracentesis, chest drainage |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.