Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot
CPT®
32605

CPT® Code 32605
Deleted

Code deleted, see 32601

Official Description

Thoracoscopy, diagnostic (separate procedure); mediastinal space, 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 mediastinal space, which is the area in the chest between the lungs that contains vital structures such as the heart, trachea, esophagus, and major blood vessels. During this procedure, the patient is typically positioned in a lateral decubitus position, which involves lying on one side. This positioning facilitates access to the thoracic cavity. To perform the thoracoscopy, one-lung ventilation is utilized, resulting in the collapse of the contralateral lung to create a clear working space for the surgeon. The procedure involves making two or three small incisions in the chest wall, through which a thoracoscope—a thin, lighted tube equipped with a camera—is inserted, along with any necessary surgical instruments. The thoracoscope can be introduced at specific intercostal spaces, such as the sixth or seventh, located at the middle axillary line or along the anterior or posterior axillary lines. Once inside the thoracic cavity, the surgeon can visualize and examine the mediastinal structures. The mediastinal pleura, which is the membrane surrounding the mediastinum, is then opened to allow for a thorough examination of the mediastinal space. During this examination, any fluid present may be aspirated for analysis, and any abnormalities, such as lesions or masses, can be documented. Additionally, photographs may be taken to provide a visual record of any findings. It is important to note that if biopsies are performed during this procedure, the appropriate code to use is 32606, which covers the collection of tissue samples from mediastinal structures, including the thymus, lymph nodes, or any identified masses or lesions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The diagnostic thoracoscopy procedure is indicated for various clinical scenarios where visualization of the mediastinal space is necessary. The following conditions may warrant this procedure:

  • Evaluation of Mediastinal Masses - This procedure is performed to assess any masses located within the mediastinal space, which may be indicative of tumors or other pathological conditions.
  • Investigation of Lymphadenopathy - Patients presenting with enlarged lymph nodes in the mediastinal region may require thoracoscopy for further evaluation and diagnosis.
  • Assessment of Pleural Effusion - In cases where there is an accumulation of fluid in the pleural space, thoracoscopy can be utilized to visualize the source and nature of the effusion.
  • Diagnosis of Inflammatory Conditions - Conditions such as sarcoidosis or infections that affect the mediastinal structures may be investigated through this procedure.

2. Procedure

The diagnostic thoracoscopy procedure involves several key steps to ensure effective visualization and examination of the mediastinal space. The following procedural steps are typically followed:

  • Step 1: Patient Positioning - The patient is positioned in a lateral decubitus position, which allows optimal access to the thoracic cavity. This positioning is crucial for the subsequent steps of the procedure.
  • Step 2: Anesthesia and Ventilation - The procedure is performed under general anesthesia, and one-lung ventilation is initiated. This technique collapses the contralateral lung, providing a clear field for the surgeon to work within the thoracic cavity.
  • Step 3: Incision Creation - Two or three small incisions are made in the chest wall. These incisions are strategically placed to allow for the introduction of the thoracoscope and any necessary surgical instruments.
  • Step 4: Insertion of Thoracoscope - The thoracoscope is inserted through one of the incisions, typically at the sixth or seventh intercostal space, located at the middle axillary line or along the anterior or posterior axillary lines. This instrument provides visualization of the thoracic cavity.
  • Step 5: Examination of the Mediastinal Space - Once the thoracoscope is in place, the thoracic cavity is thoroughly examined. The mediastinal pleura is opened to allow direct access to the mediastinal space, where any abnormalities can be identified.
  • Step 6: Fluid Aspiration and Documentation - If fluid is present in the mediastinal space, it may be aspirated for further analysis. Any abnormalities, such as lesions or masses, are noted, and photographs may be taken to document the findings.

3. Post-Procedure

After the diagnostic thoracoscopy procedure, the patient is monitored for any immediate complications related to the surgery. Post-procedure care typically includes pain management and observation for signs of respiratory distress or bleeding. The patient may be advised to avoid strenuous activities for a specified period to allow for proper healing. Follow-up appointments may be scheduled to discuss the findings from the procedure and any further diagnostic or therapeutic steps that may be necessary based on the results obtained during the thoracoscopy.
Short Descr THORACOSCOPY DIAGNOSTIC
Medium Descr THORACOSCOPY DX MEDIASTINAL SPACE W/O BIOPSY SPX
Long Descr Thoracoscopy, diagnostic (separate procedure); mediastinal space, 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 40 - Other diagnostic procedures of respiratory tract and mediastinum
Date
Action
Notes
2012-01-01 Deleted Code deleted, see 32601
2011-01-01 Changed Short description changed.
1994-01-01 Added Code added.
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"