CPT® Code 32491

Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed

The procedure identified by CPT® Code 32491 is known as lung volume reduction surgery (LVRS). This surgical intervention is designed to remove damaged lung tissue, specifically targeting areas affected by emphysema, which may present as either bullous or non-bullous lesions. The term "lung volume reduction" refers to the process of excising portions of the lung to improve overall respiratory function by reducing hyperinflation and allowing the remaining healthy lung tissue to expand more effectively. In cases where LVRS is performed on both lungs, a sternal split approach is utilized, which involves making an incision in the center of the chest and splitting the sternum to access the lungs. Conversely, if the procedure is limited to one lung, a transthoracic approach is employed, involving an incision made between the ribs. During the surgery, the physician carefully removes the compromised lung tissue, which may account for up to 30% of the emphysematous lung, and subsequently sutures or staples the surrounding tissue together, a process referred to as plication. It is important to note that this procedure may also include any pleural procedures that are performed concurrently, as these are considered part of the overall surgical approach.