CPT® Code 32504

Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction

The procedure described by CPT® Code 32504 involves the surgical resection of a tumor located at the apex of the lung, commonly referred to as a Pancoast tumor. These tumors are characterized by their tendency to invade surrounding structures, including the chest wall, lymphatic vessels, and various neural components such as the brachial plexus and intercostal nerves. The surgical approach typically involves a posterolateral thoracotomy, which is an incision made in the back that extends around the side of the chest, allowing for adequate access to the lung apex. In cases where the tumor has infiltrated the chest wall, the procedure may necessitate the removal of one or more ribs and the dissection of neurovascular structures. The extent of the resection can vary significantly; it may involve the removal of the apical lung segment, the upper lobe, or in more severe cases, the entire lung along with the affected chest wall. Following the resection, chest tubes are placed to facilitate drainage, and the incision is closed with sutures. If chest wall reconstruction is required after the tumor removal, this is also included in the procedure, and the appropriate coding must be applied to reflect the complexity of the surgical intervention.