Summary & Overview
CPT 32486: Lung Resection with Bronchial Repair
CPT code 32486 represents surgical resection of part of the lung with repair of the resected bronchus by connecting the cut ends (bronchial anastomosis). This procedure is used in thoracic surgery for a range of indications that require removal of diseased lung tissue while restoring airway continuity. Nationally, accurate coding of complex thoracic resections affects quality reporting, hospital case mix, and reimbursement pathways for surgical and perioperative care.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the service, typical sites of service, and the common payer landscape. The publication summarizes benchmark considerations, coding nuances tied to surgical scope, and the clinical context clinicians and billing teams should expect when documenting and submitting claims for this service.
This resource provides clear guidance on what the code denotes, how it fits into thoracic surgical service lines, and what topics are relevant for operational teams and policy analysts, including reimbursement benchmarks, coding validation points, and implications for hospital reporting. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 32486 describes a surgical procedure in which the provider removes a portion of the lung (a lobectomy or segmental resection of lung tissue) and repairs the resected bronchus by connecting the cut ends (bronchial anastomosis). This service is a thoracic surgical procedure performed for conditions requiring resection of lung tissue with restoration of airway continuity.
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Service type: Surgical resection of lung tissue with bronchial repair (thoracic surgery)
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Typical site of service: Hospital inpatient or hospital outpatient surgical setting (operating room), depending on clinical indication and perioperative needs.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 60-year-old with a malignant pulmonary lesion in the right upper lobe diagnosed by imaging and bronchoscopy. The patient presents with persistent hemoptysis, progressive dyspnea, and a PET-CT showing a solitary resectable tumor with involvement of the lobar bronchus. After multidisciplinary review, the thoracic surgeon schedules a sleeve lobectomy with bronchial anastomosis to remove the affected lobe while preserving lung parenchyma and reconstructing the bronchus.
Preoperative workflow includes pulmonary function testing (spirometry, DLCO), cardiopulmonary risk assessment, anesthesia evaluation, informed consent, and staging (CT chest, PET-CT, possible mediastinoscopy). Intraoperative steps: general endotracheal anesthesia, thoracotomy or video-assisted thoracoscopic approach, lobectomy with circumferential resection of the involved bronchus, and repair by end-to-end bronchial anastomosis. Specimens are sent for frozen section and final pathology. Postoperative care includes pain control, chest tube management, respiratory therapy, monitoring for anastomotic leak or stricture, and discharge planning with follow-up imaging and oncology referral as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure performed at non-facility? (payer-specific) | Use per payer rules when required to indicate standard service; rarely used with facility billing. |