Summary & Overview
CPT 32160: Open-Chest Cardiac Massage for Cardiac Arrest
CPT code 32160 represents an emergency surgical procedure: open-chest (thoracotomy) manual cardiac massage performed during cardiac arrest. As a high-acuity, life-saving intervention, this code captures invasive resuscitative care that typically occurs in acute hospital settings such as operating rooms or emergency departments. Nationally, accurate capture of this code matters for clinical quality measurement, resource planning, and payment for emergent surgical services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 32160, common billing and documentation considerations, and the types of benchmarks and policy topics relevant to emergent thoracotomy and open-chest cardiac massage. The content outlines where the service is typically delivered, the clinical scenarios that prompt use of this code, and the implications for hospital coding workflows.
This publication provides national-level context rather than state-specific guidance. It identifies the primary clinical use of the code, summarizes the payer landscape covered here, and indicates areas where policy updates, reimbursement rules, and quality reporting intersect with coding for emergency surgical resuscitation. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 32160 describes an emergency open-chest cardiac massage performed through a surgical incision into the chest cavity to allow manual compression of the heart during cardiac arrest. The procedure is a direct, invasive resuscitative technique used when closed-chest cardiopulmonary resuscitation is inadequate or not possible.
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Service type: Emergency surgical resuscitation
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Typical site of service: Operating room, emergency department procedure area, or other acute hospital setting where immediate surgical intervention is performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult found in sudden cardiac arrest in the emergency department, operating room, or inpatient ward after unsuccessful external cardiopulmonary resuscitation. The patient has refractory ventricular fibrillation or pulseless electrical activity unresponsive to closed-chest compressions, defibrillation, and advanced cardiac life support medications. The clinical team—usually a cardiothoracic surgeon or trauma surgeon with anesthesia and critical care support—performs an emergent left anterolateral thoracotomy or median sternotomy to gain direct cardiac access. A pericardial incision is made if needed, and direct manual cardiac massage is performed to generate circulation while definitive interventions (open internal cardiac massage, control of hemorrhage, cardiac repair, or extracorporeal membrane oxygenation cannulation) are initiated. Documentation includes indication (cardiac arrest refractory to closed-chest CPR), time of incision, approach, attempts at closed-chest resuscitation, personnel present, response to internal massage, and any adjunct procedures performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons of different specialties work together as primary surgeons during the emergency thoracotomy and internal cardiac massage. |
23 |