title: Malignant pleural effusions: management options with consideration of coding, billing, and a decision approach.
abstract: Malignant pleural effusions (MPEs) are a troublesome and debilitating complication of advanced malignancies, with > 150,000 cases in the United States each year. The standard management approach begins with a diagnostic and/or therapeutic thoracentesis. Should the MPE recur, a more definitive management strategy is often undertaken with several approaches available to the chest physician or surgeon. These options include repeat thoracentesis, tube thoracostomy with chemical pleurodesis, placement of an indwelling cuffed, tunneled pleural catheter with or without pleurodesis, or medical pleuroscopy or video-assisted thoracoscopic surgery with pleurodesis. Each approach has unique advantages, disadvantages, and likelihood of successful symptom relief and pleurodesis. This article will provide a general review of MPE management strategies including information concerning coding, billing, documentation, and a decision approach among these various methods.
authors.affiliation: Interventional Pulmonary Program, Jefferson Medical College of Thomas Jefferson University, Pulmonary and Critical Care Medicine, 834 Walnut St, Sixth Floor, Philadelphia, PA 19107, USA. andrew.haas@jefferson.edu
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Haas
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Sterman
authors.forename: Ali I
authors.initials: AI
authors.lastname: Musani
mesh_terms: D003661:Decision Support Techniques; D005568:Forms and Records Control; D006801:Humans; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000628:therapy*; D012051:Reimbursement Mechanisms; D014481:United States