2025 CPT code 32662
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
Thoracoscopic surgical excision of a mediastinal cyst, tumor, or mass.
Modifiers may be applicable depending on circumstances such as multiple procedures (modifier 51), reduced services (modifier 52), or distinct procedural services (modifier 59).
Medical necessity is established by the presence of a symptomatic or potentially life-threatening mediastinal cyst, tumor, or mass.Pre-operative imaging typically demonstrates the need for intervention.The risk of compression on vital structures or malignant potential often warrants surgical removal.Medical necessity must be documented clearly.
Thoracic surgeon performs the procedure, requiring expertise in minimally invasive thoracic surgery and mediastinal anatomy.Pre-operative evaluation, including imaging studies (CT scan, MRI), is necessary. Intraoperative assessment of the lesion is also crucial. Post-operative care, including chest tube management and pain control, is within the clinical responsibility of the surgeon.
In simple words: The doctor uses a small camera and instruments inserted through tiny cuts in the chest to remove a cyst, tumor, or mass from the space between the lungs. This space contains the heart and other important organs. A small tube may be left in place to drain fluid.
This procedure involves a minimally invasive surgical approach using thoracoscopy (video-assisted thoracic surgery or VATS) to visualize and remove a cyst, tumor, or mass located in the mediastinum. The mediastinum is the central compartment of the chest cavity, situated between the lungs and containing vital structures such as the heart, great vessels, trachea, esophagus, and lymph nodes. The surgeon makes small incisions in the chest wall, inserts a thoracoscope (a thin, lighted tube with a camera), and uses specialized instruments to excise the lesion.The procedure may involve partial lung collapse to improve visualization.A chest tube is typically placed for post-operative drainage.
Example 1: A 45-year-old presents with a mediastinal cyst detected on a routine chest X-ray.Thoracoscopic excision is performed to remove the cyst, alleviating potential respiratory symptoms., A 60-year-old patient with a known mediastinal mass shows enlarging size on recent imaging. VATS is used to resect the mass, and the specimen is sent for pathologic analysis to determine if it is benign or malignant., A 30-year-old patient presents with symptoms suggestive of a mediastinal tumor.A thoracoscopic approach is selected for biopsy and resection of the lesion.Intraoperative frozen section analysis guides the extent of resection.
* Pre-operative imaging studies (CT scan, MRI) showing the lesion.* Operative report detailing the approach, findings, and extent of resection.* Pathology report confirming the diagnosis and nature of the excised tissue.* Post-operative imaging (chest X-ray) to assess lung re-expansion.* Documentation of post-operative course and any complications.
** The use of this code implies that the mediastinal lesion is accessible via a thoracoscopic approach.If the procedure requires a thoracotomy (open chest surgery), a different code would be appropriate. The code does not encompass diagnostic thoracoscopy alone; it is specifically for excision of a lesion.
- Payment Status: Active
- Modifier TC rule: Not applicable to this procedure.
- Specialties:Thoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center