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2025 CPT code 32669

Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy).

Diagnostic thoracoscopy is included in the VATS segmentectomy code and should not be reported separately. If additional procedures are performed on the same lung, such as a wedge resection in a different lobe, modifier 59 may be used to indicate a distinct procedural service.

Modifiers may be applicable to this code to denote specific circumstances such as increased procedural services (22), or the presence of other procedures during the same surgical session. Modifier 59 may be necessary to distinguish a separate segmentectomy performed on a different lobe or lung.

Medical necessity for a VATS segmentectomy must be supported by documentation demonstrating that the procedure is the most appropriate treatment for the patient's condition. This typically involves demonstrating the size, location, and type of lesion, as well as the patient's overall health status and suitability for this minimally invasive approach. The goal is to show that the benefits of removing the affected lung segment outweigh the risks of surgery.

The surgeon is responsible for performing the procedure, which includes positioning the patient, creating the incisions, inserting the thoracoscope and instruments, dissecting the lung segment, controlling bleeding, removing the segment, and closing the incisions. They also manage postoperative care.

IMPORTANT:For removal of two lung segments, use 32670; for removal of an entire lung (pneumonectomy), use 32671.If a wedge resection is performed instead of a segmentectomy, see codes 32505, 32506, 32666, 32667. Use 32507 or 32668 if a diagnostic wedge resection is performed prior to the segmentectomy in the same location.

In simple words: This procedure involves using a small camera and instruments inserted through small cuts in the chest to remove a section of one lung. This allows the surgeon to see inside the chest and remove the diseased part of the lung while minimizing the impact on the rest of the lung.

This code describes a surgical procedure involving thoracoscopy (visualization of the chest cavity using an endoscope) combined with the removal of a single segment of the lung (segmentectomy).This is typically performed for small, localized lung cancers or other lesions where preservation of lung tissue is desirable. It involves inserting a thoracoscope and surgical instruments through small incisions in the chest, dissecting and dividing the segmental bronchus, artery, and vein, and then removing the targeted lung segment.

Example 1: A patient with a small, stage I lung cancer located in a single segment of the lung undergoes a VATS segmentectomy to remove the tumor while preserving the remaining lung tissue., A patient with a benign lung tumor confined to a single segment undergoes a VATS segmentectomy to remove the mass and prevent complications., A patient with a localized fungal infection in one lung segment undergoes a VATS segmentectomy to remove the infected tissue.

Documentation should include the operative report detailing the thoracoscopic approach, the specific lung segment removed, intraoperative findings (including any complications), and postoperative status. Pathology reports confirming the diagnosis and margin status are also essential. Preoperative imaging studies (CT scan, PET scan) should be documented to justify the medical necessity of the procedure.

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