2025 CPT code 32674
(Active) Effective Date: N/A Revision Date: N/A Surgery - Thoracoscopy Surgical Procedures on the Respiratory System Feed
Surgical thoracoscopy with mediastinal and regional lymphadenectomy; this is an add-on code and should be reported in addition to the code for the primary procedure.
Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual and NCCI edits for appropriate modifier usage.
The medical necessity for this procedure is determined by the presence of a clinical indication requiring evaluation and/or removal of mediastinal and/or regional lymph nodes.The indication could be a suspected malignancy, staging of known cancer, or other specific clinical conditions requiring this surgical intervention. The documentation must clearly support the need for the procedure in the given clinical context.
Thoracic surgeon or a qualified physician with training in thoracic surgery.The physician is responsible for the entire procedure, including pre-operative planning, intraoperative technique, and post-operative care.
- Surgical Procedures on the Respiratory System
- Surgical Procedures on the Respiratory System > Thoracoscopy
In simple words: This code describes a surgical procedure where a doctor uses a small camera and instruments inserted through tiny cuts in the chest to examine and remove lymph nodes in the chest area. This procedure is usually done in addition to other treatments for lung cancer or other conditions affecting the lungs.
This CPT code represents surgical thoracoscopy (video-assisted thoracic surgery [VATS]) that includes mediastinal and regional lymphadenectomy.It's an add-on code, meaning it's reported in addition to the primary procedure code.The procedure involves visualizing the chest cavity and removing mediastinal and regional lymph nodes.Specific lymph node locations vary based on the side of the body (left or right).This procedure is often performed to treat lung cancer or other thoracic malignancies.The approach may involve incisions, the insertion of trocars (ports) to hold instruments and endoscopes for visualization, excision of lymph nodes, wound closure, and placement of a chest tube for drainage.
Example 1: A 65-year-old male presents with a suspicious lung mass detected on CT scan.A VATS procedure is performed, during which a wedge biopsy is taken and sent for frozen section analysis.The pathology report confirms malignancy, and a lobectomy is performed.Code 32674 is reported in addition to the codes for the lobectomy and the biopsy., A 70-year-old female with a known history of lung cancer undergoes a VATS procedure to evaluate mediastinal lymph nodes for metastatic disease.Regional lymphadenectomy is performed.Code 32674 is reported in addition to any other codes for the primary procedure performed during the VATS., A 50 year old male presents with recurrent pleural effusion that was refractory to thoracentesis.A VATS is performed, with a pleural biopsy taken and sent for pathological analysis.Additionally, during the procedure, a mediastinal lymph node dissection is completed.Code 32674 will be reported with the appropriate pleural biopsy code.
* Operative report detailing the procedure, including the approach (VATS), the extent of lymphadenectomy (mediastinal and regional lymph nodes removed, specific locations if possible), and any other procedures performed.* Pathology report confirming the removal of mediastinal and regional lymph nodes.* Preoperative imaging studies (CT scans, etc.) showing the location of the lymph nodes targeted for removal.* Anesthesia record documenting the type and duration of anesthesia.* Post-operative notes detailing the patient's recovery and any complications.
** Always refer to the most up-to-date CPT codebook and coding guidelines for the most accurate coding and billing practices.Appropriate documentation is crucial for proper reimbursement.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is an add-on code.
- Specialties:Thoracic Surgery, Cardiothoracic Surgery, Pulmonary Surgery, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center