CPT® Code 32655

Surgical thoracoscopy, commonly known as video-assisted thoracoscopic surgery (VATS), is a minimally invasive surgical procedure used to access the thoracic cavity. This technique involves making a small incision, typically located between the fifth or sixth ribs, just below the tip of the scapula. The procedure begins with the identification of the pleura, the membrane surrounding the lungs, through digital palpation. A trocar is then inserted to facilitate the introduction of a thoracoscope, which is a specialized camera that allows the surgeon to visualize the thoracic cavity on a monitor. To perform the necessary surgical interventions, two or more additional incisions are made to accommodate the insertion of surgical instruments. In the context of CPT® Code 32655, the procedure specifically addresses the treatment of one or more blebs or bullae, which are air-filled sacs that can form on the lung surface and may lead to complications such as pneumothorax. The thoracic cavity is inspected using the thoracoscope, and any pleural adhesions are carefully dissected using diathermy or sharp and blunt dissection techniques. To locate any leaking blebs or bullae, sterile saline is instilled into the pleural space. Once identified, the bleb or bulla is grasped with an endoscopic grasper or forceps, and a linear endoscopic stapler and cutter are utilized to perform resection-plication. This involves placing multiple lines of staples at the site of the bleb or bulla to effectively seal it and prevent further air leakage. Additionally, the procedure may include other pleural interventions, such as a parietal pleurectomy, which are encompassed within the scope of CPT® Code 32655. This comprehensive approach allows for effective management of pleural conditions while minimizing the invasiveness of traditional thoracic surgery.