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Code deleted, see 32554, 32555

Official Description

Thoracentesis with insertion of tube, includes water seal (eg, for pneumothorax), when performed (separate procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 32422 refers to thoracentesis with the insertion of a drainage tube, which is performed to alleviate conditions such as pneumothorax or pleural effusion. In this procedure, a physician accesses the pleural cavity, the space between the lungs and the chest wall, to remove excess fluid or air that may be causing respiratory distress. The physician typically utilizes imaging techniques, such as ultrasound, to accurately identify the location of the fluid pocket within the pleural space. This ensures that the procedure is performed safely and effectively. The initial step may involve making a small incision in the skin to facilitate the insertion of the catheter. A needle or trocar is then carefully advanced between the ribs into the pleural cavity, allowing for the aspiration of pleural fluid. Once the fluid is obtained, a catheter is threaded over the needle and positioned within the pleural cavity to enable continuous drainage. The aspirated fluid is collected and labeled for further pathologic examination, which is crucial for diagnosing underlying conditions. This procedure is classified as a separate procedure, indicating that it is distinct from other surgical interventions that may be performed concurrently.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The thoracentesis procedure described by CPT® Code 32422 is indicated for several specific conditions that necessitate the removal of fluid or air from the pleural cavity. These indications include:

  • Pneumothorax - The presence of air in the pleural space, which can lead to lung collapse and requires drainage to restore normal lung function.
  • Pleural effusion - Accumulation of excess fluid in the pleural cavity, which can cause difficulty in breathing and may require therapeutic drainage.
  • Diagnostic purposes - To obtain pleural fluid for laboratory analysis to determine the underlying cause of pleural effusion, such as infection, malignancy, or inflammatory conditions.

2. Procedure

The thoracentesis procedure involves several critical steps to ensure safe and effective drainage of the pleural cavity. The steps are as follows:

  • Step 1: Patient Preparation - The patient is positioned appropriately, often sitting upright, to facilitate access to the pleural space. The physician may use ultrasound or other imaging techniques to identify the optimal site for needle insertion, ensuring that the procedure targets the area with the most fluid accumulation.
  • Step 2: Skin Preparation - The skin over the selected thoracentesis site is cleaned and sterilized to minimize the risk of infection. A local anesthetic may be administered to reduce discomfort during the procedure.
  • Step 3: Insertion of Needle or Trocar - A needle or trocar is carefully advanced between the ribs and into the pleural cavity. The physician monitors for the presence of pleural fluid, which indicates successful entry into the pleural space.
  • Step 4: Catheter Placement - Once pleural fluid is obtained, a catheter is threaded over the needle and advanced into the pleural cavity. This allows for continuous drainage of the fluid.
  • Step 5: Aspiration of Fluid - The physician uses a syringe or vacuum bottle to aspirate the pleural fluid. The fluid is collected for analysis, which may include laboratory tests to determine its composition and underlying cause.
  • Step 6: Securing the Catheter - After the procedure, the catheter is secured in place to maintain drainage, and the site is dressed appropriately to protect it from infection.

3. Post-Procedure

After the thoracentesis procedure, the patient is monitored for any immediate complications, such as bleeding or infection at the insertion site. The physician may perform a follow-up imaging study, such as a chest X-ray, to ensure that the procedure was successful and to check for any potential complications, such as re-accumulation of fluid or pneumothorax. Patients are typically advised on signs of complications to watch for, such as increased shortness of breath, chest pain, or fever. Follow-up appointments may be scheduled to review the results of the fluid analysis and to determine if further intervention is necessary.

Short Descr THORACENTESIS W/TUBE INSERT
Medium Descr THORACENTESIS WITH INSERTION TUBE WATER SEAL
Long Descr Thoracentesis with insertion of tube, includes water seal (eg, for pneumothorax), when performed (separate procedure)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Discontinued Code
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 39 - Incision of pleura, thoracentesis, chest drainage
Date
Action
Notes
2013-01-01 Deleted Code deleted, see 32554, 32555
2013-01-01 Changed Short and Medium Descriptors changed.
2008-01-01 Added Code added
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