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Radiology Coding Alert

Reader Question:

Note Subtle Differences Between 32020 and 32002

Question: How can we distinguish 32002 from 32020? We confuse these two codes all the time. Mississippi Subscriber Answer: You should report 32002 (Thoracentesis with insertion of tube with or without water seal [e.g., for pneumothorax] [separate procedure]) if the radiologist uses a chest tube with or without a water seal or a Heimlich valve to treat a pneumothorax (for instance, after a lung biopsy). Radiologists usually secure such tubes in place, but they don't normally stitch these as strongly as they secure tubes that they use for fluid drainage.

According to the November 2003 CPT Assistant, you should report 32020 (Tube thoracostomy with or without water seal [e.g., for abscess, hemothorax, empyema] [separate procedure]) if the radiologist inserts a tube into the pleural space for drainage of a pleural effusion or empyema and secures the drain "to remain in place for an extended period of drainage from the pleural space."

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