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The procedure described by CPT® Code 32562 involves the instillation of a fibrinolytic agent via a chest tube or catheter into the pleural space, specifically on a subsequent day following the initial treatment. This procedure is typically performed after a patient has undergone an initial instillation of a fibrinolytic agent, which is coded under CPT® Code 32561. The primary purpose of this procedure is to address multiloculated effusions, which are collections of fluid in the pleural space that can become trapped due to the formation of fibrinous bands or loculations. The use of fibrinolytic agents, such as streptokinase or urokinase, is crucial as they work to break down these fibrinous structures, thereby facilitating improved drainage of purulent material from the pleural space. The process begins with the cleansing of the skin and administration of a local anesthetic, followed by the insertion of a chest tube or catheter. Once the fluid is drained, the fibrinolytic agent is instilled, and the chest tube is temporarily closed to allow the agent to disperse throughout the pleural space. After sufficient time has passed for the agent to act, the chest tube is reopened to suction out both the fibrinolytic agent and any remaining purulent material. This procedure may require the chest tube to remain in place for several days to ensure adequate drainage and recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure coded under CPT® Code 32562 is indicated for patients presenting with multiloculated effusions, which are characterized by the presence of fluid collections in the pleural space that are compartmentalized due to fibrinous bands or loculations. These conditions may arise from various underlying causes, including infections, malignancies, or inflammatory processes that lead to the accumulation of purulent material. The instillation of a fibrinolytic agent is performed to enhance the drainage of this fluid and to prevent complications associated with retained effusions.
The procedure begins with the preparation of the patient, which includes cleansing the skin over the chest area and administering a local anesthetic to minimize discomfort during the intervention. Following this, a small incision is made to facilitate the insertion of a chest tube or catheter into the pleural space. If fluid is present, it is drained to clear the area for the subsequent instillation of the fibrinolytic agent. The fibrinolytic agent, such as streptokinase or urokinase, is then carefully instilled through the chest tube or catheter. This agent is crucial for breaking down the fibrinous bands or loculations that may be obstructing fluid drainage. After the instillation, the chest tube is temporarily closed to allow the fibrinolytic agent to spread throughout the pleural space, maximizing its effectiveness. Once adequate time has elapsed for the agent to act, the chest tube is reopened, and both the fibrinolytic agent and any purulent material are suctioned out of the pleural space. This process may require the chest tube to remain in place for several days to ensure continued drainage and recovery of the patient.
After the procedure, the patient is monitored for any complications, such as bleeding or infection at the insertion site. The chest tube may remain in place for several days to facilitate ongoing drainage of fluid from the pleural space. Healthcare providers will assess the output from the chest tube regularly to ensure that adequate drainage is occurring. Patients may also require follow-up imaging studies to evaluate the effectiveness of the fibrinolytic therapy and to monitor for any recurrence of the effusion. Pain management and supportive care are also important aspects of post-procedure care to ensure patient comfort and recovery.
| Short Descr | LYSE CHEST FIBRIN SUBQ DAY | Medium Descr | INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY | Long Descr | Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 41 - Other non-OR therapeutic procedures on respiratory system |
| 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) | 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. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AG | Primary physician | 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 | CR | Catastrophe/disaster related | FS | Split (or shared) evaluation and management visit | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | 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 | SA | Nurse practitioner rendering service in collaboration with a physician | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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