CPT 1023T: Percutaneous Image-Guided Intrathoracic Tissue Displacement

CPT code 1023T designates an add-on, percutaneous intrathoracic tissue displacement procedure performed under imaging guidance to move tissues aside during a primary chest intervention. This code matters nationally because it captures a discrete, image-guided technical step that may affect procedural coding, aggregate service intensity, and facility billing for thoracic interventions. Accurate use supports clear reporting of the technical work involved in complex image-guided chest procedures.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of the code’s clinical context and service setting, together with benchmarking and policy-relevant considerations where available. The publication highlights how the code functions as an adjunct to primary thoracic procedures, typical sites of service (hospital outpatient departments and ambulatory surgical centers), and implications for coding workflows.

The analysis provides benchmarks for utilization and reimbursement patterns, outlines common billing and documentation practices tied to add-on imaging-guided thoracic steps, and summarizes policy updates or payer guidance when available. Data limitations are noted where input information is incomplete; readers receive practical, nationally oriented context to inform coding, billing oversight, and administrative planning related to CPT code 1023T.

Billing Code Overview

CPT code 1023T describes an add-on percutaneous intrathoracic tissue displacement procedure performed in conjunction with a primary intrathoracic intervention. The provider uses imaging guidance to advance instruments percutaneously and move intrathoracic tissues aside to facilitate access to target structures within the chest.

Service type: Percutaneous image-guided tissue displacement as an add-on procedure
Typical site of service: Hospital outpatient department, ambulatory surgical center, or other facilities where image-guided thoracic procedures are performed

Data not available in the input.

Clinical Context

A patient with a centrally located pulmonary nodule adjacent to vital mediastinal structures is scheduled for a percutaneous image-guided diagnostic or therapeutic thoracic procedure. The primary procedure may be a transthoracic needle biopsy, catheter placement, ablation, or other intrathoracic intervention. During the case, the operator determines that intrathoracic tissues (for example, lung parenchyma, mediastinal fat, or an adherent pleural segment) obstruct safe access to the target. Using a percutaneous approach and continuous imaging guidance (fluoroscopy, CT, or ultrasound), the provider temporarily displaces or retracts intrathoracic tissue to create a safe corridor to the lesion.

A typical workflow:

Pre-procedure evaluation includes review of prior imaging (CT chest), coagulation status, and informed consent for the primary procedure and potential add-on maneuvers.
In the procedure suite or interventional radiology/operating room, the patient is positioned and local anesthesia and/or conscious sedation/general anesthesia is administered per institutional protocol.
Image guidance (CT-fluoroscopy or cone beam CT with fluoroscopy) is used to plan an access path. If tissue displacement is required to avoid major vessels, airway, or to minimize risk of pneumothorax, the operator performs a percutaneous tissue displacement maneuver.
The add-on maneuver (1023T) is documented separately from the primary procedure: indication for displacement, imaging modality used, technique (needle/catheter used to lever or push tissue), duration, immediate imaging confirmation of safe access, and any immediate complications.
The primary procedure (biopsy, drain placement, or ablation) is then completed through the created corridor. Post-procedure imaging confirms target sampling/therapy and absence of immediate complications. Standard recovery and post-procedure instructions are provided.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	When a separate E/M visit is performed on the same date as the procedure and is not bundled with the interventional service
`26`	Professional component	When reporting only the physician professional component distinct from the technical imaging component
`50`	Bilateral procedure	When the tissue displacement maneuver is performed on both hemithoraces in the same session
`59`	Distinct procedural service	When the displacement maneuver is separate and distinct from another procedure performed the same day (use cautiously per carrier guidance)
`76`	Repeat procedure by same physician	When the displacement maneuver is repeated later the same day by the same provider
`77`	Repeat procedure by another physician	When the displacement maneuver is repeated later the same day by a different provider
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	When an unplanned repeat displacement is required during the global period and return to procedure room occurs
`79`	Unrelated procedure or service by the same physician during the postoperative period	When a different, unrelated procedure is performed during the global period
`GA`	Waiver of liability statement on file (Medicare-specific)	When the provider has a signed Advance Beneficiary Notice (ABN) for a non-covered service
`XE`	Separate encounter, a service that is distinct because it occurred during a separate encounter	When documentation supports a separate encounter distinct from the primary procedure (use with caution)
`XS`	Separate structure — a service that is distinct because it was performed on a separate organ/structure	When the displacement maneuver is performed on a separate intrathoracic structure distinct from the primary procedure's organ

Taxonomy Code	Specialty	Notes
207RC0000X	Interventional Radiology	Primary specialty performing percutaneous image-guided thoracic interventions
207RI0010X	Diagnostic Radiology	Radiologists who perform image-guided biopsies and related maneuvers
2084P0800X	Thoracic Surgery	Thoracic surgeons who perform percutaneous and surgical thoracic procedures
2086S0125X	Pulmonology	Interventional pulmonologists performing percutaneous/bronchoscopic combined procedures
364S00000X	Critical Care Medicine	Providers involved when critically ill patients require bedside image-guided thoracic interventions

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Central or peripheral lung tumors often require image-guided biopsy or ablation where tissue displacement may be needed
`J93.9`	Pneumothorax, unspecified	Risk and management considerations when performing percutaneous thoracic procedures; tissue displacement may reduce risk of lung injury
`J91.8`	Other pleural effusion	Presence of pleural effusion can alter access; displacement may be used to optimize sampling or therapy
`R91.8`	Other nonspecific abnormal finding of lung field	Indeterminate pulmonary nodules requiring tissue diagnosis via percutaneous approach
`C78.01`	Secondary malignant neoplasm of right lung	Metastatic intrathoracic lesions requiring targeted biopsy or ablation where displacement creates safe access
`C78.02`	Secondary malignant neoplasm of left lung	Same clinical relevance for left-sided lesions
`R09.3`	Abnormal sputum	Symptom that may prompt imaging and subsequent percutaneous diagnostic procedures
`Z48.02`	Encounter for change or removal of thoracic drainage device	Post-procedural care codes relevant when drains or devices are placed as part of thoracic interventions

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32405`	Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance	Performed before or after displacement when pleural fluid is present; imaging-guided variants often accompany planning
`32410`	Thoracentesis, with imaging guidance	Imaging-guided pleural access that may precede or follow tissue displacement maneuvers when fluid evacuation is required
`32440`	Percutaneous needle biopsy, lung; single lobe	The primary diagnostic procedure that `1023T` may facilitate by creating a safer access path
`32505`	Tube thoracostomy, including water seal (e.g., chest tube)	May be performed after biopsy/ablation if pneumothorax or persistent air leak occurs
`32601`	Thoracoscopy, surgical; diagnostic, with or without biopsy	Surgical thoracoscopic procedures that may be alternatives when percutaneous displacement is not possible
`50592`	Percutaneous ablation, renal mass; radiofrequency or cryoablation (analogous percutaneous ablation codes)	Example of percutaneous ablation workflow where tissue displacement add-on might be used in thoracic ablation scenarios (technique relationship)

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Summary & Overview