Summary & Overview
CPT 32652: Thoracoscopic Lung Decortication, Video-Assisted
CPT code 32652 identifies a video-assisted thoracoscopic decortication procedure in which the provider removes the fibrous pleural peel and adhesions to free the lung and improve expansion. This code captures a commonly performed thoracic surgical intervention for trapped lung or organized pleural disease and is relevant to hospitals, ambulatory surgical centers, and payers managing high-acuity procedural care. Nationally, accurate coding for this procedure affects inpatient and outpatient surgical claims, resource use, and authorization workflows.
Key payers in the discussion include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical description of the service, typical sites of service, and the common modifiers associated with reporting surgical services for this code. The publication summarizes coding considerations, typical clinical indications, and operational implications for billing and utilization management across major payers. It also outlines what to expect in documentation and claims submission when this invasive thoracoscopic decortication is performed.
This summary is intended for clinicians, coding professionals, and policy analysts seeking a concise reference on the clinical and billing identity of CPT code 32652 and its role in surgical thoracic care.
Billing Code Overview
CPT code 32652 describes a video-assisted endoscopic procedure to perform decortication of the lung. The provider strips away the thin fibrous membrane (the visceral pleural peel), removes adhesions in the pleural space, and divides tissues attaching the lung to the chest wall to improve lung expansion.
Service type: Surgical — thoracic/endoscopic decortication
Typical site of service: Operating room or endoscopy/ambulatory surgical center with thoracic surgery capability, often requiring general anesthesia and perioperative monitoring.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of long-standing fibrothorax and recurrent pleural effusions presents with progressive dyspnea and reduced pulmonary expansion on the right side. Prior attempts at chest tube drainage and medical management provided only temporary relief. Imaging (chest CT) demonstrates thickened pleural peel with entrapped lung. After multidisciplinary review, the patient is scheduled for a video-assisted thoracoscopic surgery (VATS) pleural decortication to remove the fibrous visceral pleural rind, lyse adhesions, and allow re-expansion of the lung.
The clinical workflow includes preoperative evaluation (history, pulmonary function testing, anesthesia assessment), informed consent discussing risks and benefits of VATS decortication, preoperative optimization (anticoagulation management, chest physiotherapy), operating room setup with thoracoscopic equipment, general endotracheal anesthesia with single-lung ventilation if indicated, placement of thoracoscopic ports, visualization and careful stripping of the pleural peel, hemostasis, placement of chest tube(s), and postoperative monitoring in recovery with chest radiography and chest tube management until air leak resolution and adequate expansion are achieved. Typical site of service is the hospital operating room with postsurgical inpatient observation or admission based on clinical status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |