CPT® Code 32609

Thoracoscopy with biopsy of the pleura is a minimally invasive surgical procedure used to examine the pleural space, which is the area between the lungs and the chest wall. This procedure allows for direct visualization of the pleura, the membrane surrounding the lungs, and is typically performed to investigate abnormalities such as pleural effusions, tumors, or infections. During thoracoscopy, various techniques may be employed to access the pleural space safely. One common method involves blunt entry, where a clamp is passed over a rib to penetrate the pleura. This is followed by a digital inspection of the entry site to confirm sufficient space for the insertion of the thoracoscope, a specialized instrument used for viewing the pleura. The thoracoscope is then inserted under direct vision, allowing the physician to inspect the pleura for any irregularities. In some cases, fluid may be removed from the pleural space using suction catheters to facilitate a clearer view. Tissue samples, or biopsies, are collected from the pleura to aid in diagnosis. Another technique may involve making a small incision in the chest wall to insert a trocar, which creates an entry point for the thoracoscope. This method may also include the induction of an artificial pneumothorax by injecting air into the pleural space, enhancing visualization. Throughout the procedure, any lesions or abnormalities are documented, and photographs may be taken prior to obtaining biopsies. After the examination, a chest tube or catheter may be placed if necessary, and the incisions are closed to complete the procedure.