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Thoracoscopy, surgical, with diagnostic wedge resection is a minimally invasive procedure aimed at evaluating diseased or damaged lung tissue. This technique is particularly useful in determining the extent of lung resection required during a subsequent anatomic lung resection, which is a more extensive surgical intervention that may be performed in the same surgical session. The procedure typically involves the use of a thoracoscope, a specialized instrument that allows the surgeon to visualize the thoracic cavity and the lung structures without the need for large incisions. The wedge resection is performed through a single portal incision, and the specific location of the incision and the thoracoscope's placement is determined by the location of the lung lesion being assessed. During the procedure, the surgeon identifies the lesion and utilizes an endograsper to grasp and suspend it for further evaluation. An endostapler is then employed to excise a wedge of lung tissue containing the lesion, ensuring that the tissue is carefully removed while minimizing damage to surrounding healthy lung parenchyma. The resected tissue is subsequently placed in an endobag for removal, and a chest tube may be inserted to facilitate drainage. This procedure is critical for obtaining tissue samples for pathology examination, which will inform the decision regarding any necessary definitive lung procedures that may follow.
© Copyright 2025 Coding Ahead. All rights reserved.
Thoracoscopic surgical procedures, including diagnostic wedge resection, are indicated for various conditions affecting the lung. The following are explicitly provided indications for performing this procedure:
The procedure for thoracoscopic surgical wedge resection involves several critical steps, each designed to ensure accurate evaluation and safe removal of lung tissue. The following procedural steps are outlined:
After the thoracoscopic wedge resection, the patient is monitored for any complications, such as bleeding or infection. The chest tube remains in place to allow for proper drainage and to prevent pneumothorax. The expected recovery period may vary depending on the extent of the procedure and the patient's overall health. A separate pathology examination of the resected tissue is performed, and the results will guide the decision regarding any further definitive lung procedures that may be necessary. Patients are typically advised on post-operative care, including pain management and activity restrictions, to ensure optimal recovery.
| Short Descr | THORACOSCOPY W/W RESECT DIAG | Medium Descr | THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN | Long Descr | Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | 2 | CCS Clinical Classification | 36 - Lobectomy or pneumonectomy |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 32440 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Removal of lung, pneumonectomy; | 32442 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy) | 32445 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Removal of lung, pneumonectomy; extrapleural | 32480 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Removal of lung, other than pneumonectomy; single lobe (lobectomy) | 32482 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy) | 32484 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Removal of lung, other than pneumonectomy; single segment (segmentectomy) | 32486 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy) | 32488 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy) | 32503 | MPFS Status: Active Code APC C Physician Quality Reporting Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s) | 32504 | MPFS Status: Active Code APC C Physician Quality Reporting Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction | 32663 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Thoracoscopy, surgical; with lobectomy (single lobe) | 32669 | MPFS Status: Active Code APC C Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy) | 32670 | MPFS Status: Active Code APC C Thoracoscopy, surgical; with removal of two lobes (bilobectomy) | 32671 | MPFS Status: Active Code APC C Thoracoscopy, surgical; with removal of lung (pneumonectomy) |
| RT | Right side (used to identify procedures performed on the right side of the body) | 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) | 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). | 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. | 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. | 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). | CR | Catastrophe/disaster related | 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 | 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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| 2012-01-01 | Added | Added |