© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 32940 refers to pneumonolysis, which is a surgical technique aimed at collapsing a portion of the lung to treat conditions such as pulmonary tuberculosis. In this specific procedure, the pneumonolysis is performed extraperiosteally, meaning that the surgical approach involves working outside the periosteum, the membrane covering the bones. The goal of this intervention is to create a controlled collapse of one side of the chest, which can help in managing the complications associated with pulmonary tuberculosis. The procedure involves a significant incision and dissection of various anatomical structures, including the skin, muscles, and ribs, to access the lung tissue. The removal of a section of the third rib, and potentially a portion of the fourth rib, is necessary to facilitate the dissection of the lung from the chest wall. This meticulous process allows the surgeon to free the diseased lung tissue from its attachments, ultimately leading to the desired lung collapse. The procedure concludes with the maintenance of this collapse by either filling the intrathoracic space with air or packing it with gauze or other materials, ensuring that the lung remains in its collapsed state for effective treatment.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of pneumonolysis, as described by CPT® Code 32940, is primarily indicated for the treatment of pulmonary tuberculosis. This condition often leads to complications that may necessitate surgical intervention to manage the disease effectively. The procedure is performed when conservative treatments are insufficient, and there is a need to collapse a portion of the lung to alleviate symptoms or prevent further complications associated with the disease.
The pneumonolysis procedure involves several critical steps to ensure effective treatment. Initially, a long posterolateral skin incision is made over the third rib, allowing access to the underlying structures. This incision is carefully extended through the subcutaneous tissue to reach the trapezius and rhomboid muscles, which are then incised to expose the rib cage. Following this, a long section of the third rib is removed to facilitate access to the lung. In some cases, a smaller portion of the fourth rib may also be excised to enhance visibility and access to the affected lung tissue. The intercostal muscles, which are located between the ribs, are sectioned to further expose the area. During this process, the intercostal nerve is identified and sectioned to prevent pain during and after the procedure. The surgeon then meticulously dissects the adherent, diseased portion of the lung from the chest wall using forceps and scissors, followed by finger dissection to ensure thorough removal of the affected tissue. The pneumonolysis typically extends from the third rib down to the sixth rib and spans from the axillary region to the mediastinum. Once sufficient collapse of the lung has been achieved, the procedure is concluded by filling the intrathoracic space with air or packing it with gauze or other packing materials to maintain the lung's collapsed state.
Post-procedure care following pneumonolysis involves monitoring the patient for any complications that may arise from the surgery. Patients are typically observed for signs of respiratory distress or infection. Pain management is also an essential aspect of post-operative care, as the surgical site may be sensitive due to the extensive dissection and rib removal. The patient may require follow-up imaging studies to assess the effectiveness of the lung collapse and to ensure that the intrathoracic space remains appropriately filled. Recovery time can vary based on the individual patient's health status and the extent of the procedure performed, but close monitoring and follow-up care are crucial to ensure a successful recovery.
| Short Descr | REVISION OF LUNG | Medium Descr | PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX | Long Descr | Pneumonolysis, extraperiosteal, including filling or packing procedures | 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 | 42 - Other OR therapeutic procedures on respiratory system |
| 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.