2025 CPT code 32503
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Respiratory System Feed
Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s).
Modifiers may be applicable in certain situations.For example, if the procedure is performed on the left lung, modifier -LT may be appended.
Medical necessity should be established by pre-operative imaging and/or biopsy demonstrating the presence of the apical lung tumor and its location.Documentation should support the need for the extensive resection involving the chest wall, ribs, and neurovascular structures.
The surgeon performs a thoracotomy to access the apical lung tumor.They may use rib spreaders for better access.The tumor is removed, and if it has spread, the surgeon may resect portions of the chest wall, ribs, nerves, or blood vessels. The incision is then closed.
In simple words: The surgeon removes a tumor located at the top of the lung, which may involve removing parts of the chest wall, ribs, and nearby nerves and blood vessels. This specific procedure does not include rebuilding the chest wall.
This procedure involves the removal of an apical lung tumor, often a Pancoast tumor. It includes resection of the chest wall, ribs, and neurovascular dissection as necessary.It specifically describes the procedure when chest wall reconstruction is *not* performed.
Example 1: A patient presents with a Pancoast tumor at the apex of the right lung. The surgeon performs a thoracotomy and resects the tumor, along with portions of the first and second ribs and associated intercostal nerves and vessels, without chest wall reconstruction. Code 32503 is reported., A patient is diagnosed with a malignant apical lung tumor that has invaded the chest wall. During surgery, the surgeon removes the tumor, the involved portion of the chest wall, and a segment of the affected rib. No chest wall reconstruction is performed. Code 32503 is used., A patient with a large apical lung tumor requires resection. The surgeon performs a thoracotomy. During the procedure, portions of two adjacent ribs are resected for adequate access and removal of the tumor. The surgeon does not perform chest wall reconstruction. Code 32503 is applied.
Operative report detailing the thoracotomy approach, size and location of the apical lung tumor, extent of chest wall resection (including ribs, nerves, and vessels), and confirmation that chest wall reconstruction was *not* performed.Pathology report confirming the diagnosis.
** As of December 1, 2024, this information reflects the most current available data. Refer to current CPT coding guidelines and fee schedules for the most up-to-date information.
- Payment Status: Active
- Specialties:Thoracic Surgery, Surgical Oncology
- Place of Service:Inpatient Hospital