| MP 7.01.36 | Thoracoscopic Laser Ablation of Emphysematous Pulmonary Bullae | |
| Medical Policy | ||
| Section Surgery |
Original Policy Date 3/31/96 |
Last Review Status/Date Reviewed with literature search/4:2003 |
| Issue 4:2003 |
Return to Medical Policy Index |
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Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.
Description
Thoracoscopic laser ablation of emphysematous pulmonary bullae involves the use of defocused carbon dioxide laser energy applied to bullous lesions through a thoracoscope in the pleural space. In cases of deep or extensive thick-walled bullous lesions, partial excision is sometimes performed through the thoracoscope with the use of an endoscopic electrocautery spatula.
Policy
Thoracoscopic laser ablation of pulmonary bullae is considered investigational.
Policy Guidelines
No applicable information
Benefit Application
BlueCard/National Account Issues
No applicable information.
Rationale
The original policy was based on a 1995 TEC Assessment that concluded that there were inadequate published data to permit scientific conclusions. (1) A literature search based on the MEDLINE database was performed for the period of 1995 to June 2003. No published literature regarding this procedure was identified, suggesting that this procedure is now largely obsolete.
References:
- TEC Assessments, 1995: Tab 33
|
Codes |
Number |
Description |
|
CPT |
32655 |
Thoracoscopy with excision placation of bullae, including any pleural procedure |
|
ICD-9 Procedure |
32.28 |
Endoscopic excision or destruction of lesion or tissue of lung |
|
ICD-9 Diagnosis |
|
Investigational for all codes |
|
HCPCS |
No code |
|
|
Type of Service |
Surgery |
|
|
Place of Service |
Inpatient |
|
Index
Ablation, thoracoscopic laser, of emphysematous pulmonary bullae
Pulmonary bullae, thoracoscopic laser ablation
Thoracoscopic laser ablation of emphysematous pulmonary bullae
Policy History
|
Date |
Action |
Reason |
|
03/31/96 |
Add to Surgery section |
New policy |
|
04/15/02 |
Replace policy |
Policy reviewed without literature review; new review date only |
|
12/17/03 |
Replace policy |
Policy reviewed with literature search; policy statement unchanged. |
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