Ask Dr. Z

"Under US guidance the physician punctured the pleural space, placed a catheter, drained fluid, and then removed the catheter (32555). Then he did a limited US and saw there was still moderate pleural effusion, so decision was made to place a drainage tube. Local anesthesia was applied to same puncture site, then needle again was placed into pleural space followed by placement of a drainage catheter that was stitched into place (32557)." Since the physician removed the first tube and a decision was made to place a drainage tube, would we code both 32555-59 and 32557? Or should we just report the 32557 since 32555 is inclusive of 32557?