2025 CPT code 32540
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Respiratory System Feed
Extrapleural enucleation of empyema (empyemectomy).
Modifiers may be applicable, such as -59 (Distinct Procedural Service) if performed with another procedure in a different anatomical location. If performed at the same time as a lobectomy, use the lobectomy code and 32540 with modifier -59.
Medical necessity for 32540 is established when an empyema is present and is causing symptoms or posing a risk to the patient's health. This may be due to infection, inflammation, or compression of surrounding structures. Failure of conservative management, such as antibiotics or drainage, may also support the medical necessity of surgical intervention.
The surgeon is responsible for performing the extrapleural enucleation of empyema. This includes making the incision, carefully dissecting the empyema from surrounding tissues, repairing any lung tears, closing the incision, and placing chest drains if necessary.
In simple words: The surgeon removes a pocket of pus (empyema) from the chest cavity without cutting into the lung. This is done through an incision in the chest wall. The pus is carefully separated from the lining of the lung and removed.
This procedure involves the removal of an empyema (a collection of pus within the pleural space) from outside the pleural lining of the lung. The procedure is performed through a thoracotomy incision in the chest.The empyema is carefully separated from the lung and surrounding tissues and removed. The pleural lining is preserved as much as possible, and any tears in the lung are repaired. The chest incision is then closed, and chest drains may be placed to facilitate lung re-expansion and drainage of any remaining fluid or air.
Example 1: A patient presents with an empyema located between the lung and the chest wall, causing shortness of breath and fever. The surgeon performs an extrapleural enucleation (32540) to remove the empyema without damaging the lung., A patient with a history of pneumonia develops a large, complex empyema that is not responding to antibiotic therapy. The surgeon performs an extrapleural enucleation to remove the infection., A patient with tuberculosis develops an empyema that requires surgical intervention. An extrapleural enucleation is performed to remove the infected fluid and surrounding tissue.
Documentation should include details of the empyema's size, location, complexity, and the operative technique used. Any associated procedures, such as lung repair or chest tube placement, should also be documented. Preoperative imaging and intraoperative findings should be included.
- Revenue Code: P1G - Major Procedure - Other
- Global Days: 90 days
- Specialties:Thoracic Surgery
- Place of Service:Inpatient Hospital