CPT® Code 32605

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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.