CPT® Code 32997

The CPT® Code 32997 refers to a medical procedure known as total lung lavage, specifically performed on one lung (unilateral). This procedure is primarily indicated for the treatment of pulmonary alveolar proteinosis, a rare lung condition characterized by the abnormal accumulation of surfactant within the alveoli, which are the tiny air sacs in the lungs responsible for gas exchange. The buildup of surfactant can lead to significant respiratory issues, necessitating intervention. During the procedure, the physician administers oxygen to the patient prior to the lavage to enhance oxygen saturation levels, ensuring the patient is adequately oxygenated before undergoing the procedure. Following this, a general anesthetic is given, and the patient is intubated using a double lumen endotracheal tube. This specialized tube allows for one-lung ventilation, enabling the physician to perform the lavage on the affected lung while maintaining ventilation in the untreated lung. The procedure involves measuring the baseline compliance of both lungs, clamping the lung to be treated to facilitate oxygen absorption, and instilling heated normal saline into the lung. Chest percussion is utilized during the saline instillation to aid in the mobilization of the surfactant. The saline is subsequently drained, and the process of instillation and recovery is repeated several times to ensure thorough lavage. After the final cycle, a Valsalva maneuver is performed, along with aggressive bronchial suctioning, to clear any remaining surfactant. The lung compliance is then re-evaluated to confirm it has returned to baseline levels. The procedure concludes with the extubation of the patient once end-tidal CO2 and pulse oxygen saturation levels normalize.