CPT® Code 32036

The procedure described by CPT® Code 32036 involves a thoracostomy with open flap drainage specifically for the treatment of empyema, which is an accumulation of pus in the pleural cavity. This surgical intervention is necessary when there is a need to drain an abscess located within the pleural space. The process begins with the physician making a small incision in the chest wall, strategically positioned over the rib that is situated above the empyema collection. To access the pleural space, a segment of the rib is excised, allowing entry into the cavity where the empyema resides. The physician then meticulously breaks down any loculated cavities within the pleural space, which may involve using a fingertip or suction tip to ensure thorough drainage. Following this, the empyema collection is aspirated, and the area is irrigated with an antibiotic solution to help prevent infection. A large bore chest tube is subsequently inserted through a separate incision to facilitate ongoing drainage. In the specific procedure denoted by CPT® Code 32036, an open, U-shaped skin flap is created over the site of the empyema to ensure effective drainage and to maintain the opening for continued fluid removal. This flap is designed to extend sufficiently to reach the pleural cavity without causing tension. Additionally, a section of rib is removed, and the tip of the flap is turned inward and sutured to the parietal pleura, which is the membrane lining the chest wall. This technique allows for open drainage of the empyema collection, promoting healing and recovery.