CPT® Code 32556

The procedure described by CPT® Code 32556 involves the percutaneous drainage of the pleural space through the insertion of an indwelling catheter, specifically performed without the use of imaging guidance. This procedure is commonly utilized to alleviate conditions where there is an accumulation of air (pneumothorax) or fluid (pleural effusion) within the chest cavity, which can compromise respiratory function. The process begins with the physician inserting an introducer needle into the pleural cavity, allowing access for further instrumentation. Following this, an introducer wire is threaded through the needle, which is subsequently removed to facilitate the placement of a dilator. The dilator is advanced into the pleural cavity to enlarge the puncture site, making it easier to insert the catheter. Once the dilator is removed, the catheter is placed over the wire, and the wire is taken out. In some cases, a small incision may be made at the 4th or 5th intercostal space to access the pleura directly. A Kelly clamp may be used to create a pneumothorax, allowing for the insertion of the chest tube. After placement, the catheter or tube is secured with sutures and connected to a suction unit, which may include a water seal chamber to prevent air from re-entering the pleural space. It is important to note that if imaging guidance such as ultrasound, fluoroscopy, or CT is utilized during the procedure, CPT® Code 32557 should be reported instead.