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Sleeve lobectomy is a surgical procedure that entails the removal of a lobe of the lung, along with a circumferential segment of the bronchus that supplies air to the affected lobe. This procedure is particularly significant in cases where tumors are located centrally within the lung, especially in the right upper lobe, and cannot be adequately addressed through a standard lobectomy. The operation involves a careful dissection and resection of both lung tissue and bronchial structures, followed by the reconnection of the remaining bronchial segments to ensure continued airflow to the lung. The surgical approach typically requires an incision made at the front of the chest, which is then extended around to the back, allowing access to the thoracic cavity. During the procedure, the lung is deflated, and major blood vessels are clamped and tied off to minimize bleeding. The affected lobe and the diseased portion of the bronchus are excised, and the remaining bronchus is meticulously reattached to the main bronchus, facilitating normal respiratory function post-surgery. This technique is essential for preserving lung function while effectively removing pathological tissue, making it a critical option in thoracic surgery.
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The sleeve lobectomy procedure is indicated for specific conditions and symptoms that necessitate the removal of lung tissue along with a segment of the bronchus. These include:
The sleeve lobectomy involves several critical procedural steps, which are outlined as follows:
Post-procedure care following a sleeve lobectomy includes monitoring for complications such as infection, bleeding, or respiratory issues. Patients may require a temporary drainage tube to manage fluid and air in the pleural space, which is typically removed once the lung has adequately re-expanded. Recovery may involve pain management and respiratory therapy to support lung function. The expected recovery time can vary based on the individual patient's health status and the extent of the surgery performed.
| Short Descr | SLEEVE LOBECTOMY | Medium Descr | RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY | Long Descr | Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy) | 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.
| 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. | 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. | 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) |
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| 2012-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Medium description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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