2025 CPT code 32554
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance.
Modifiers may be applicable in certain circumstances. Refer to current CPT guidelines for modifier usage.
Medical necessity must be established for this procedure. The documentation should clearly indicate the clinical rationale for the thoracentesis, such as symptomatic pleural effusion, pneumothorax, or suspected infection.
The physician prepares the patient, administers local anesthesia, inserts the needle or catheter into the pleural space, aspirates the fluid or air, and bandages the site. The aspirated fluid may be sent for laboratory analysis.
In simple words: This procedure involves removing fluid, blood, or air from the space between the lungs and chest wall using a needle or a catheter, without imaging guidance. The patient is seated and leaning forward. After numbing the area, the doctor inserts a thin needle or catheter between the ribs. The fluid is then drained and sent to a lab, and the area is bandaged.
This code describes a procedure where a needle or catheter is used to aspirate fluid or air from the pleural space without the use of imaging guidance.
Example 1: A patient presents with shortness of breath and pleural effusion. A thoracentesis is performed without imaging guidance to remove the fluid for diagnostic and therapeutic purposes., A patient with a pneumothorax requires aspiration of air from the pleural space. Thoracentesis is performed without imaging guidance to relieve the pressure on the lung., A patient with suspected empyema undergoes thoracentesis without imaging guidance to collect a sample of pleural fluid for culture and analysis.
Documentation should include the indication for the procedure, patient consent, details of the procedure performed, amount and character of fluid aspirated, any complications, and post-procedure care. If fluid is sent for analysis, the results should also be documented.
** Medicare carriers may issue Local Coverage Decisions (LCDs) listing criteria that must be met prior to coverage. Physicians are urged to review these policies.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Specialties:Pulmonary Medicine, Critical Care Medicine, Interventional Radiology, Thoracic Surgery.
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Independent Clinic.