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Completion pneumonectomy is a surgical procedure that entails the removal of the remaining portion of a lung in patients who have previously undergone lung surgery, specifically where a part of the lung was excised. This procedure is typically indicated when the remaining lung tissue is no longer functional or poses a risk to the patient's health. The surgery begins with an incision made at the front of the chest, which may be extended around to the back, providing access to the thoracic cavity. During the operation, the surgeon may need to remove a rib to enhance visibility and access to the lung. Once the chest cavity is opened, the remaining lung portion is deflated, and the major blood vessels supplying the lung are carefully ligated to prevent excessive bleeding. The main bronchus, which is the airway leading to the lung, is clamped and incised to facilitate the removal of the lung tissue. After the lung is excised, the bronchus is closed off using staples or sutures to ensure that air does not escape into the pleural space. To aid in recovery and prevent complications, a temporary drainage tube may be placed in the pleural cavity to evacuate any air, fluid, or blood that may accumulate post-surgery. Finally, the chest incision is meticulously closed to promote healing.
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The completion pneumonectomy procedure is indicated for patients who have previously undergone lung surgery involving the removal of a portion of the lung. The specific indications for this procedure may include:
The completion pneumonectomy involves several critical procedural steps, which are outlined as follows:
Post-procedure care following a completion pneumonectomy is critical for patient recovery. Patients are typically monitored closely for any signs of complications, such as bleeding or infection. The temporary drainage tube inserted during the surgery is usually monitored and may be removed once it is determined that there is no longer a need for drainage. Patients may experience pain at the incision site, which can be managed with appropriate analgesics. Rehabilitation and respiratory therapy may be initiated to help improve lung function and overall recovery. Follow-up appointments are essential to assess the surgical site and ensure that the patient is healing properly.
| Short Descr | COMPLETION PNEUMONECTOMY | Medium Descr | RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC | Long Descr | Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy) | 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. | 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. | 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) |
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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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