2025 CPT code 32445
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgical Procedures on the Respiratory System - Removal Procedures on the Lungs and Pleura Surgery Feed
Removal of lung, pneumonectomy; extrapleural.
Modifiers may be applicable depending on the circumstances of the surgery. For example, modifier 59 (distinct procedural service) could be used if additional procedures are performed on a different lung or lobe.Consult the official CPT manual and NCCI edits for guidance.
Medical necessity for a pneumonectomy is established by the presence of a malignant lung tumor or other life-threatening condition affecting the lung that requires surgical removal.The extent of resection should be justified by the preoperative evaluation and intraoperative findings. Documentation must show the medical necessity for the surgical procedure and the extent of the resection.
Thoracic surgeon.Requires expertise in thoracic surgery, including incision, lung collapse, vascular ligation, bronchus management, pleural dissection, and chest closure techniques. Post-operative care and monitoring.
- Surgery
- Surgical Procedures on the Respiratory System > Removal Procedures on the Lungs and Pleura
In simple words: The doctor removes the entire lung and any visible cancer in the lining of the chest, heart, and diaphragm. This involves making a cut in the chest, removing the lung, and closing the incision.
This CPT code, 32445, represents the surgical removal of an entire lung (pneumonectomy) and any visible cancerous tissue in the parietal pleura lining the chest wall, heart, and diaphragm.The procedure involves an incision (sternotomy or thoracotomy), potential rib spreading for better access, lung collapse, ligation of affected blood vessels, clamping and severing of the diseased lung's bronchus, removal of the lung, excision of the parietal pleura, and closure of the incision.If a sternotomy was performed, the sternum is wired back together. The code specifically covers cases where the removal extends to portions of the diaphragm and pericardium.
Example 1: A 65-year-old male presents with a large, centrally located lung mass confirmed as malignant on biopsy.A right pneumonectomy (32445) is performed, including resection of involved parietal pleura. , A 72-year-old female with a history of asbestos exposure and malignant pleural mesothelioma undergoes an extrapleural pneumonectomy (32445 and 32540) with resection of the involved parietal pleura. , A 58-year-old male with a large malignant lung tumor involving the chest wall requires a pneumonectomy (32445) and resection of a portion of the rib cage (21601-21603), both performed concurrently.
Preoperative imaging (CT scan, MRI), pathology reports (biopsy results), operative report detailing the extent of resection, postoperative imaging (chest x-ray), and pathology report on the resected specimen.Documentation must support medical necessity.
** This code should only be reported when an extrapleural pneumonectomy is performed.Always consult the official CPT manual and NCCI edits for the most up-to-date coding guidelines and to ensure accurate billing.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not provided and would need to be obtained from a relevant fee schedule and potentially adjusted based on geographic location, facility type, and other payer-specific factors.
- Global Days: The global period for this procedure would vary depending on payer and the complexity of the surgery.Additional information would need to be consulted.
- Payment Status: Active
- Modifier TC rule: The TC (Technical Component) modifier is not typically used with this code.
- Fee Schedule: Historical fee schedule data is not included here and would need to be obtained from relevant payer sources.Fee schedules can vary significantly based on payer, geographic location, and other factors.
- Specialties:Thoracic Surgery
- Place of Service:Inpatient Hospital