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CPT 32400: Percutaneous Pleural Biopsy, Diagnostic Tissue Sampling

CPT code 32400 denotes a percutaneous pleural biopsy: a needle-based procedure to obtain pleural tissue for pathological analysis. This code is important nationally because pleural biopsies play a central role in diagnosing pleural malignancy, tuberculosis, and other causes of pleural disease, influencing downstream treatment decisions and utilization of advanced therapies.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and what to expect from payer coverage and billing perspectives. The publication outlines common modifiers and coding considerations, benchmarks for claim processing and denial patterns where available, and recent policy or guideline updates that affect clinical documentation and medical necessity justification.

This summary equips revenue cycle staff, clinicians, and policy analysts with a focused reference on CPT code 32400: its clinical purpose, billing context, and the types of documentation and claim components that commonly accompany percutaneous pleural biopsy services. Data not available in the input will be identified where applicable.

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Billing Code Overview

CPT code 32400 describes a percutaneous pleural biopsy in which the provider obtains tissue samples from the pleura using a needle and sends specimens for pathological analysis. This procedure is a diagnostic pleural intervention used to evaluate pleural disease, including suspicion for malignancy, infection, or other inflammatory processes.

Service type: Percutaneous pleural biopsy (diagnostic tissue sampling)
Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgical center, depending on patient stability and clinical setting.

Data not available in the input.

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CPT 32400: Percutaneous Pleural Biopsy, Diagnostic Tissue Sampling

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Billing Code Overview

Service type: Percutaneous pleural biopsy (diagnostic tissue sampling)
Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgical center, depending on patient stability and clinical setting.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a history of smoking and progressive shortness of breath presents with a persistent unilateral pleural effusion on chest radiograph and CT scan. The pulmonologist performs a percutaneous pleural needle biopsy using image guidance (ultrasound or CT) to obtain tissue samples for histopathology and microbiology to distinguish malignant pleural disease from infectious or inflammatory causes. The procedure is typically done in an interventional radiology suite or procedure room, with local anesthesia and conscious sedation as needed. The samples are submitted to pathology and cytology; the clinician documents indication, consent, imaging guidance used, number of passes, any immediate complications (e.g., pneumothorax), and disposition. Billing uses CPT 32400 for the percutaneous pleural biopsy with tissue sent for pathological analysis. Typical encounter includes pre-procedure evaluation, the biopsy procedure, post-procedure monitoring including chest radiograph if clinically indicated, and communication of results to the ordering clinician.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation portion of a diagnostic service (rare for this procedure).
`50`	Bilateral procedure	When bilateral pleural biopsies are performed in the same session (uncommon).
`51`	Multiple procedures	When `32400` is billed with other distinct procedures on the same day; may indicate multiple procedure payment rules.
`52`	Reduced service	When the biopsy is attempted but incomplete or limited (e.g., insufficient sample due to technical factors).
`53`	Discontinued procedure	When the procedure is started but terminated due to patient instability or other contraindication prior to tissue acquisition.
`59`	Distinct procedural service	When another non-overlapping procedure is performed the same day and needs to be distinguished from the biopsy.
`62`	Two surgeons	When two surgeons operate together and both perform substantive work during the biopsy.
`76`	Repeat procedure by same physician	When the same physician repeats the biopsy within the global period (useful if additional sampling is required same day or later).
`77`	Repeat procedure by another physician	When a different physician repeats the biopsy within the global period.
`78`	Unplanned return to the operating/procedure room	When the patient returns for a related procedure due to a complication from the biopsy (e.g., persistent bleeding).
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period.
`26`	Professional component	Duplicate entry removed: use only once.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Pulmonary Disease	Interventional pulmonologists commonly perform pleural biopsies with image guidance.
`207H00000X`	Thoracic Surgery	Thoracic surgeons may perform pleural biopsies, especially when surgical thoracoscopy is considered.
`207K00000X`	Interventional Radiology	Interventional radiologists frequently perform percutaneous pleural biopsies under CT or ultrasound guidance.
`207L00000X`	Internal Medicine	Hospitalist or general internists may coordinate care and perform bedside pleural procedures in select settings.
`208000000X`	Pathology	Pathologists receive and analyze specimens; included here as an associated provider specialty for specimen processing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Suspicion of metastatic or primary lung malignancy with pleural involvement prompting pleural biopsy.
`C78.2`	Secondary malignant neoplasm of respiratory and digestive systems	Suspected metastatic disease to the pleura requiring tissue diagnosis.
`J90`	Pleural effusion, not elsewhere classified	Diagnostic pleural biopsy may be indicated when effusion etiology is unclear after thoracentesis.
`J91.0`	Malignant pleural effusion	Direct indication for pleural sampling to confirm malignancy and define histology.
`J15.9`	Unspecified bacterial pneumonia	Infectious processes with pleural involvement may prompt biopsy when standard testing is non-diagnostic.
`A15.0`	Tuberculosis of lung	Tuberculous pleuritis can require pleural biopsy for histology and culture when pleural fluid is non-diagnostic.
`R09.1`	Pleurisy	Inflammatory pleural disease that may be investigated with tissue sampling if persistent or atypical.
`R91.8`	Other nonspecific abnormal findings of lung field	Imaging findings suspicious for pleural-based lesions that require tissue diagnosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32550`	Insertion of indwelling tunneled pleural catheter (e.g., PleurX)	Performed when recurrent malignant effusion is diagnosed or anticipated after biopsy results.
`32554`	Thoracentesis, needle or catheter, aspiration of the pleural space	Often performed prior to or in conjunction with diagnostic biopsy to remove fluid for cytology and symptomatic relief.
`32601`	Thoracoscopy, surgical; with diagnostic biopsy(s) of pleura	Alternative diagnostic approach when percutaneous biopsy is non-diagnostic or when direct visualization is required.
`71045`	Radiologic examination, chest, single view, frontal	A post-procedure chest radiograph is commonly performed to evaluate for pneumothorax following pleural biopsy.
`77012`	Computed tomography guidance for needle placement (e.g., biopsy, aspiration)	Used when CT guidance is employed to localize the pleural lesion for percutaneous biopsy.

CPT 32310: Parietal Pleurectomy (Chest Wall Pleurectomy)

CPT-32320-DECORTICATION-PARIETAL-PLEURECTOMY

CPT 32320: Decortication and Parietal Pleurectomy

CPT-32408-LUNG-MEDIASTINAL-CORE-NEEDLE-BIOPSY-IMAGE-GUIDED

CPT 32408: Image-Guided Core Needle Biopsy of Lung or Mediastinum

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation portion of a diagnostic service (rare for this procedure).
`50`	Bilateral procedure	When bilateral pleural biopsies are performed in the same session (uncommon).
`51`	Multiple procedures	When `32400` is billed with other distinct procedures on the same day; may indicate multiple procedure payment rules.
`52`	Reduced service	When the biopsy is attempted but incomplete or limited (e.g., insufficient sample due to technical factors).
`53`	Discontinued procedure	When the procedure is started but terminated due to patient instability or other contraindication prior to tissue acquisition.
`59`	Distinct procedural service	When another non-overlapping procedure is performed the same day and needs to be distinguished from the biopsy.
`62`	Two surgeons	When two surgeons operate together and both perform substantive work during the biopsy.
`76`	Repeat procedure by same physician	When the same physician repeats the biopsy within the global period (useful if additional sampling is required same day or later).
`77`	Repeat procedure by another physician	When a different physician repeats the biopsy within the global period.
`78`	Unplanned return to the operating/procedure room	When the patient returns for a related procedure due to a complication from the biopsy (e.g., persistent bleeding).
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period.
`26`	Professional component	Duplicate entry removed: use only once.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Pulmonary Disease	Interventional pulmonologists commonly perform pleural biopsies with image guidance.
`207H00000X`	Thoracic Surgery	Thoracic surgeons may perform pleural biopsies, especially when surgical thoracoscopy is considered.
`207K00000X`	Interventional Radiology	Interventional radiologists frequently perform percutaneous pleural biopsies under CT or ultrasound guidance.
`207L00000X`	Internal Medicine	Hospitalist or general internists may coordinate care and perform bedside pleural procedures in select settings.
`208000000X`	Pathology	Pathologists receive and analyze specimens; included here as an associated provider specialty for specimen processing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Suspicion of metastatic or primary lung malignancy with pleural involvement prompting pleural biopsy.
`C78.2`	Secondary malignant neoplasm of respiratory and digestive systems	Suspected metastatic disease to the pleura requiring tissue diagnosis.
`J90`	Pleural effusion, not elsewhere classified	Diagnostic pleural biopsy may be indicated when effusion etiology is unclear after thoracentesis.
`J91.0`	Malignant pleural effusion	Direct indication for pleural sampling to confirm malignancy and define histology.
`J15.9`	Unspecified bacterial pneumonia	Infectious processes with pleural involvement may prompt biopsy when standard testing is non-diagnostic.
`A15.0`	Tuberculosis of lung	Tuberculous pleuritis can require pleural biopsy for histology and culture when pleural fluid is non-diagnostic.
`R09.1`	Pleurisy	Inflammatory pleural disease that may be investigated with tissue sampling if persistent or atypical.
`R91.8`	Other nonspecific abnormal findings of lung field	Imaging findings suspicious for pleural-based lesions that require tissue diagnosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32550`	Insertion of indwelling tunneled pleural catheter (e.g., PleurX)	Performed when recurrent malignant effusion is diagnosed or anticipated after biopsy results.
`32554`	Thoracentesis, needle or catheter, aspiration of the pleural space	Often performed prior to or in conjunction with diagnostic biopsy to remove fluid for cytology and symptomatic relief.
`32601`	Thoracoscopy, surgical; with diagnostic biopsy(s) of pleura	Alternative diagnostic approach when percutaneous biopsy is non-diagnostic or when direct visualization is required.
`71045`	Radiologic examination, chest, single view, frontal	A post-procedure chest radiograph is commonly performed to evaluate for pneumothorax following pleural biopsy.
`77012`	Computed tomography guidance for needle placement (e.g., biopsy, aspiration)	Used when CT guidance is employed to localize the pleural lesion for percutaneous biopsy.

CPT 32310: Parietal Pleurectomy (Chest Wall Pleurectomy)

CPT-32320-DECORTICATION-PARIETAL-PLEURECTOMY

CPT 32320: Decortication and Parietal Pleurectomy

CPT-32408-LUNG-MEDIASTINAL-CORE-NEEDLE-BIOPSY-IMAGE-GUIDED

CPT 32408: Image-Guided Core Needle Biopsy of Lung or Mediastinum

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 32400: Percutaneous Pleural Biopsy, Diagnostic Tissue Sampling

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Billing Code Overview

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CPT 32400: Percutaneous Pleural Biopsy, Diagnostic Tissue Sampling

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References