Video-assisted thoracoscopic surgery (VATS) has revolutionized thoracic surgery, offering patients less invasive alternatives to traditional open thoracotomy. For medical coders, auditors, and providers alike, understanding the nuances of these procedures is critical for accurate documentation, coding, compliance, and reimbursement. This presentation explores the clinical workflows, procedural variations, and coding challenges associated with VATS lung resections, biopsies, and decortications. Coding guidance will be combined with real-world operative report excerpts, focusing on identifying key language, anatomical terminology, and surgical intent. Attendees will leave with greater confidence in distinguishing between wedge resections, lobectomies, segmentectomies, and more — all through the lens of both CPT® coding and clinical relevance.