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The procedure described by CPT® Code 32482 refers to the surgical removal of two lobes of the lung, a process known as bilobectomy. This operation is typically performed through an intercostal incision, which is a cut made between the ribs in the anterior (front) part of the chest, extending around to the posterior (back) side at the level of the affected lung lobes. In cases where greater visibility and access are required, a rib may be removed to facilitate the procedure. Once the incision is made, the lung is deflated to allow for easier manipulation and access to the lobes that need to be removed. The surgeon then identifies and ligates (ties off) the main arteries and veins that supply blood to the affected lobes, ensuring that there is no bleeding during the removal process. Following this, the secondary bronchi, which are the air passages leading to the lobes, are clamped and divided. The diseased lobes are carefully dissected from the surrounding lung tissue and removed from the chest cavity. After the lobes are excised, the remaining portions of the secondary bronchi are either stapled or sutured closed to prevent air leaks. Post-surgery, the remaining lung tissue often expands to fill the space left in the chest cavity. To aid in recovery and prevent complications such as fluid accumulation, chest tubes are inserted into the pleural space. Finally, the chest incision is closed, completing the procedure. It is important to note that CPT® Code 32482 is specifically used when two lobes are removed, while CPT® Code 32480 is designated for the removal of a single lobe.
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The procedure of bilobectomy, as described by CPT® Code 32482, is indicated for various conditions affecting the lung lobes. These may include:
The bilobectomy procedure involves several critical steps to ensure the safe and effective removal of the affected lung lobes. The process begins with the surgeon making an intercostal incision in the anterior chest, which is then extended around to the posterior chest at the level of the lobes that are to be removed. If additional exposure is necessary, a rib may be excised to provide better access to the lung tissue. Once the incision is made, the lung is deflated to facilitate the surgical procedure.
Next, the surgeon identifies the main arteries and veins supplying the affected lobes. These vessels are carefully ligated and divided to prevent excessive bleeding during the operation. Following this, the secondary bronchi, which are the air passages leading to the lobes, are clamped and divided, allowing for the isolation of the diseased lobes. The surgeon then meticulously dissects the lobes from the surrounding lung tissue, ensuring that all connections are severed before removal.
After the lobes are excised, the remaining portions of the secondary bronchi are either stapled or sutured closed to prevent air leaks that could lead to complications post-surgery. Once the lobes have been successfully removed, the remaining lung tissue is expected to expand and fill the chest cavity. To assist in recovery and to prevent fluid accumulation in the pleural space, chest tubes are inserted. Finally, the incision in the chest is closed, completing the surgical procedure.
Post-procedure care following a bilobectomy is crucial for recovery. Patients are typically monitored for any signs of complications, such as bleeding or infection. The insertion of chest tubes helps to drain any excess fluid or air that may accumulate in the pleural space, which is essential for proper lung expansion and function. Patients may experience pain at the incision site, which can be managed with appropriate pain relief medications. The expected recovery time can vary, but patients are generally advised to follow up with their healthcare provider to monitor lung function and overall health. Rehabilitation may be recommended to help restore lung capacity and improve respiratory function following the surgery.
| Short Descr | BILOBECTOMY | Medium Descr | RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC | Long Descr | Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy) | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | 36 - Lobectomy or pneumonectomy |
This is a primary code that can be used with these additional add-on codes.
| 32501 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure) | 32507 | Addon Code MPFS Status: Active Code APC C Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) | 32668 | Addon Code MPFS Status: Active Code APC C Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) | 32674 | Add-on Code MPFS Status: Active Code APC C Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) | 38746 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) |
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Action
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Notes
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| 2012-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Medium description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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