2025 CPT code 32557
Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance.
Modifiers may be applicable. Modifier 50 is used for bilateral procedures. Other modifiers may be necessary depending on the specific circumstances.
Medical necessity for this procedure must be clearly documented. This includes the clinical signs and symptoms necessitating the drainage, such as respiratory distress, chest pain, or imaging evidence of fluid or air in the pleural space. The documentation should support that less invasive treatments were considered or attempted, if applicable.
The physician uses real-time imaging to guide the placement of the catheter into the pleural space. The skin is prepped, and a local anesthetic is administered. A needle may be used to access the fluid, followed by a guidewire and a dilator to create space for the catheter. The catheter is then inserted, secured, and connected to a drainage system.
In simple words: Using imaging guidance, the doctor inserts a small tube through a small incision in your chest to drain fluid or air. The tube is left in place for continued drainage.
Percutaneous pleural drainage with the insertion of an indwelling catheter using imaging guidance. This code describes a procedure where the physician uses imaging technology (such as ultrasound or CT) to guide the insertion of a catheter into the pleural space for drainage purposes. This is typically done for conditions like pleural effusions or pneumothorax.
Example 1: A patient presents with a large pleural effusion causing shortness of breath. Ultrasound guidance is used to insert a drainage catheter to remove the fluid., A patient with a pneumothorax requires chest tube placement. The physician uses CT guidance to ensure accurate placement of the catheter for air evacuation. , A patient develops a post-operative pleural effusion. Under ultrasound guidance, a catheter is inserted to drain the fluid and improve the patient's respiratory function.
Documentation should include the indication for the procedure (e.g., pleural effusion, pneumothorax), type of imaging guidance used (e.g., ultrasound, CT), the size and type of catheter inserted, and the amount of fluid or air drained. Confirmation of catheter placement via imaging should also be documented.
** Code 32557 is for percutaneous drainage with imaging guidance. For tunneled catheter placement or open procedures, use different codes (32550 and 32551 respectively). Appropriate modifiers should be appended for additional catheter placements or other distinct procedures performed during the same session.
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Ambulatory Surgical Center, and other places of service as appropriate.