CPT 39560 Diaphragm Resection Reimbursement

CPT code 39560 denotes surgical resection of the diaphragm with primary simple suture repair, a procedure often performed to remove diseased tissue such as tumor invasion of the diaphragm. This code captures a focused thoracoabdominal or thoracic surgical intervention that can occur during planned oncologic resections or as part of emergency operative management. Nationally, accurate reporting of this code matters for clinical documentation, procedure tracking, and claims processing for complex surgical care involving the diaphragm.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for 39560, how it is categorized within surgical service lines, and what to expect in terms of site-of-service patterns. The publication also outlines common billing considerations and related code groupings; however, detailed modifier use, diagnosis mappings, and payer-specific reimbursement amounts are provided where available.

This summary is intended for health policy analysts, hospital billing professionals, and surgical service line managers seeking a concise reference to the clinical intent and billing identity of CPT code 39560, along with pointers to where further payer-specific and coding guidance may be obtained.

Billing Code Overview

CPT code 39560 describes a surgical procedure in which the provider resects part of the diaphragm and repairs the defect using simple primary sutures. The description indicates the procedure is commonly performed to excise diseased tissue, such as when a tumor invades the diaphragmatic area.

Service type: Surgical resection and primary repair of diaphragm

Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room under general anesthesia

Clinical Context

A 62-year-old patient with a history of non-small cell lung carcinoma presents with localized diaphragmatic invasion identified on cross-sectional imaging and confirmed by thoracic surgical assessment. The patient is scheduled for a thoracotomy with resection of the involved diaphragmatic tissue and primary repair of the diaphragm due to tumor extension into the diaphragm muscle. The clinical workflow includes preoperative evaluation by thoracic surgery and anesthesia, imaging review (CT or PET-CT), informed consent documenting the need for diaphragm resection, intraoperative resection of the diseased diaphragm segment, primary layered suture repair of the diaphragmatic defect, intraoperative pathology consultation as needed, postoperative chest tube management, pain control, respiratory therapy, and inpatient observation with chest imaging to confirm repair integrity before discharge.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the diaphragm resection required substantially greater effort, time, or complexity than usual (extensive scarring, dense adhesions, or complex exposure).
`26`	Professional component	Use when reporting only the professional component of a service that has a distinct technical component. Rare for but applicable if facility bills technical portion separately.

Taxonomy Code	Specialty	Notes
207P00000X	Thoracic Surgery	Primary specialty performing diaphragm resections for thoracic malignancy or invasion.
207L00000X	General Surgery	General surgeons may perform diaphragmatic resections during abdominal or oncologic procedures.
208000000X	Vascular Surgery	May be involved when vascular structures near the diaphragm require management; less common primary operator.
207K00000X	Cardiothoracic Surgery	Overlaps with thoracic surgery for resections involving the chest and diaphragm.
207H00000X	Surgical Oncology	Involvement for tumor extirpation with diaphragm resection as part of oncologic resection.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Lung cancer with potential diaphragmatic invasion requiring resection and repair.
`C78.00`	Secondary malignant neoplasm of lung, unspecified	Metastatic disease to the lung that may invade the diaphragm necessitating resection.
`C79.90`	Secondary malignant neoplasm of unspecified site	Metastatic involvement of structures adjacent to the diaphragm prompting resection.
`D21.9`	Benign neoplasm of connective and other soft tissue, unspecified	Benign tumor invading or adherent to diaphragm tissues requiring excision and repair.
`S27.8XXA`	Other specified injury of thorax, initial encounter	Traumatic diaphragmatic injury scenarios where resection and primary repair may be indicated.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32663`	Excision or destruction of lung tissue, wedge resection; single lobe (thoracotomy/thoracoscopy)	May be performed alongside diaphragm resection when lung parenchyma is resected for primary tumor removal.
`32666`	Lobectomy, single lobe (including mediastinal lymphadenectomy when performed)	Performed when larger lung resection is required for tumor control and diaphragmatic resection is part of the combined oncologic procedure.
`32820`	Thoracotomy, with exploration, cardiac and mediastinal procedures incidental (separate code for extensive chest exploration)	May be listed for extensive thoracic exploration when diaphragm resection occurs during open chest surgery.
`38720`	Excision, radical, cervical lymph nodes; single or multiple groups	Commonly performed for nodal staging or clearance during oncologic thoracic surgery that includes diaphragm resection.
`32551`	Tube thoracostomy, includes water seal (eg, chest tube) with or without suction	Often performed perioperatively for drainage and lung re-expansion after diaphragm resection via thoracotomy.

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Summary & Overview

CPT 39560: Diaphragm Resection and Primary Repair