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CPT®
32603

CPT® Code 32603
Deleted

Code deleted, see 32601

Official Description

Thoracoscopy, diagnostic (separate procedure); pericardial sac, without biopsy

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Diagnostic thoracoscopy is a minimally invasive surgical procedure that allows for direct visualization of the pericardial sac, which is the double-walled structure surrounding the heart. This procedure is typically performed through small incisions made in the chest wall, specifically at the right or left midaxillary line and within the sixth or seventh intercostal space. The thoracoscope, a specialized instrument equipped with a camera and light source, is inserted to provide a clear view of the pericardial sac. During the procedure, the surgeon examines the pericardial sac for any abnormalities, such as fluid accumulation, lesions, or other pathological changes. If necessary, an incision is made in the pericardial sac to aspirate any fluid present, which is then sent for laboratory analysis to determine its composition and potential underlying causes. The procedure also includes a thorough inspection of the cardiac chambers, epicardium, and pericardium for any lesions or implants that may indicate disease. In some cases, photographs may be taken to document findings. It is important to note that if biopsies of the pericardium or epicardium are required, the appropriate code to use is 32604, as this code specifically pertains to procedures involving tissue sampling.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Diagnostic thoracoscopy (CPT® Code 32603) is indicated for various clinical scenarios where visualization of the pericardial sac is necessary. The following conditions may warrant this procedure:

  • Pericardial Effusion - Accumulation of fluid in the pericardial sac, which may require evaluation to determine the cause and appropriate management.
  • Pericarditis - Inflammation of the pericardium that may necessitate examination to assess the extent of the condition and guide treatment.
  • Pericardial Constriction - A condition where the pericardium becomes thickened and fibrotic, leading to impaired heart function, which may require direct visualization for diagnosis.
  • Suspicion of Lesions or Implants - The presence of abnormal growths or foreign materials in the pericardial area that need to be evaluated for potential malignancy or other complications.

2. Procedure

The procedure for diagnostic thoracoscopy involves several key steps that ensure effective visualization and examination of the pericardial sac. The following outlines the procedural steps:

  • Step 1: Patient Preparation - The patient is positioned appropriately, typically in a lateral decubitus position, to facilitate access to the thoracic cavity. Anesthesia is administered to ensure comfort and minimize pain during the procedure.
  • Step 2: Incision and Thoracoscope Insertion - A small incision is made in the skin at the right or left midaxillary line, usually at the sixth or seventh intercostal space. The thoracoscope is then carefully inserted through this incision into the pleural space, allowing for visualization of the pericardial sac.
  • Step 3: Visualization of the Pericardial Sac - Once the thoracoscope is in place, the surgeon examines the pericardial sac for any abnormalities. This includes looking for signs of fluid accumulation, inflammation, or lesions.
  • Step 4: Fluid Aspiration - If fluid is present in the pericardial sac, an incision is made to allow for aspiration of the fluid. This fluid is collected and sent for laboratory analysis to determine its characteristics and potential underlying causes.
  • Step 5: Inspection of Cardiac Structures - The surgeon inspects the cardiac chambers, epicardium, and pericardium for any lesions or implants that may require further evaluation or intervention. Photographs may be taken to document findings for future reference.

3. Post-Procedure

After the diagnostic thoracoscopy is completed, the patient is monitored for any immediate complications. Post-procedure care may include pain management and observation for signs of infection or bleeding. The patient may be advised on activity restrictions and follow-up appointments to discuss laboratory results from the aspirated fluid. Recovery time can vary, but many patients can resume normal activities within a few days, depending on their overall health and the extent of the procedure performed.
Short Descr THORACOSCOPY DIAGNOSTIC
Medium Descr THORACOSCOPY DX PERICARDIAL SAC W/O BIOPSY SPX
Long Descr Thoracoscopy, diagnostic (separate procedure); pericardial sac, without biopsy
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
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 62 - Other diagnostic cardiovascular procedures
Date
Action
Notes
2012-01-01 Deleted Code deleted, see 32601
2011-01-01 Changed Short description changed.
1994-01-01 Added Code added.
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