Ask Dr. Z

Dr. Z, In the area of cryoablation of the lung, I have suggested 32999 as the appropriate code, others are stating that microwave, radiofrequency and cryoablation would use the same code: 32998. Could you please clarify this as our hospital uses your guidelines but we do not have anything in writing on this issue. Another issue that has led to some confusion is that the physician used the RFA equipment but changed the needles on the equipment to perform the cryo? Documentation reads: Two 24L cryoablation needles were subsequently inserted into the lesion. Multiple adjustments in the position of the needles were made followed by limited CT scans in full expiration were performed until correct positioning was obtained. During this process, the patient developed a moderate volume pneumothorax for which an 8 French APDL pleural catheter was placed. Intermittent hand aspiration was performed to maintain lesion targeting. One run of 30 minutes was performed to ablate the lesion. The ablation needles were then removed and the tract was ablated. A sterile dressing was applied and the pleural catheter was left in placed to 20 mm Hg of wall suction. Thanks in advance for your help with this problem, Rhonda, Ancillary Manager