Is Thymectomy bundled into a total thyroidectomy?
Thank you for your time
Karen S
Thank you for your time
Karen S
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Tag Archives: Thyroidectomy
Total thyroidectomy with neuroplasty
Has anyone dealt with this???? Would the neuroplasty be billable, or included in the thyroidectomy. I cannot find a code for neuroplasy. Thank you everyone!!!
With anteromedial mobilization of the right thyroid lobe, the recurrent laryngeal nerve was identified; however, the nerve was encompassed by a fibrotic response requiring fairly meticulous dissection using the small right angle clamp as well as fine-tip tonsil to free the nerve. For this, a neuroplasty procedure was performed.
Intraoperative Ultrasound during Thyroidectomy
Hi all,
In all my 7 years of coding for ENT, this is the first time I’m coming across this and I wanted to know if what is being done is tip-toeing on the edge of over-utilization or not medically necessary….
Endo surgeon performs thyroidectomies and lobectomies all the time without any intraoperative ultrasound. All of the sudden now EVERY single case has included 76536 (Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation) and I’m concerned that this is not medically necessary. I haven’t been able to find a single scholarly article, coding article, or even Physician membership board mentioning that this is somehow routine (or even a new way of performing the surgery). I’ve worked with 2 different ENT groups and this is the first time I’m seeing them bill for 76536; 1-2 cases here and there, I can understand…this is literally every single patient on their list all of sudden.
Most of the documentation is verbatim in every op report and reads: "After induction of general endotracheal anesthesia, Intraoperative neck sonography was performed for incision site planning and to rule out interval development of malignant adenopathy or extrathyroidal extension of tumor. The patient was then prepped…"
Thyroidectomy question
Hello,
I have a question on codes for a procedure performed by one of our surgeons. I am able to find a lot of information on the procedure and what is done but nothing on cpt codes.
The provider performed a transoral endoscopic thyroidectomy with vestibular approach.
Any ideas or input on codes would be very helpful.
I have a question on codes for a procedure performed by one of our surgeons. I am able to find a lot of information on the procedure and what is done but nothing on cpt codes.
The provider performed a transoral endoscopic thyroidectomy with vestibular approach.
Any ideas or input on codes would be very helpful.
Thank you,
TB
Endoscopic thyroidectomy
Has anyone’s providers started doing this procedure? I am thinking that it can only be billed with the 60659 since the incision is in the gum line.
Total Thyroidectomy
Dear All,
Help me with the below ot notes. I coded 60252 and 60512. Plz suggest me the codes are correct or not.Our Doctor has performed – Total Thyroidectomy
Total excision of Parathyroids, and re-implantation of parathyroid.
Patient in supine position.
Collar incision at a lower neck crease; which was predetermined preoperatively.
The platysma is divided at a higher level than the skin. The flaps of the skin
and superficial fascia as well as the platysma and then reflected upwards
to the level of the thyroid cartilage, and downwards to the sternum.
The anterior jugular veins needed no division, but they were retracted laterally.
Incision of the deep fascia in the midline.
Retraction of the infrahyoid muscle and the fascial sheath laterally.
Division of the pre-tracheal fascia covering the thyroid gland.
Now the left lobe is retracted medially to expose the lateral surface of the lobe
and the upper pole of the gland is delivered out to tie off the vascular pedicle comprising
the superior thyroid vessels. The ties were applied very close to
the gland to avoid possible injury to the external laryngeal nerve.
Ties to branches of inferior thyroid artery were applied; but all ties were plicated well
away from the gland to prevent injury to the recurrent laryngeal nerve.
The left lobe is then cut and followed to remove the isthmus also.
Complete haemostasis is obtained by Fine ligatures, we avoided to use diathermy coagulation.
The left lobe has a bit of retrosternal extension,
and that required mobilization to free its intrathoracic extension.
Attention is now paid to the Right lobe of thyroid, repeating the same steps as in left lobe.
Non-absorbable ties to the Superior thyroid vessels; followed by ties to branches of inferior thyroid vessels.
A haemostatic continuous absorbable suture in the isthmus to control haemorrhage,
also with the Harmonic® scalpel.
Suction drainage is placed at the thyroid bed, and the tube was secured by silk suture.
Closure of the deep fascia, and platysma using Vicryl sutures.
Suturing of the skin using 6/0 Ethilon.
Total Thyroidectomy
Dear All,
Help me with the below ot notes. I coded 60252 and 60512. Plz suggest me the codes are correct or not.Our Doctor has performed – Total Thyroidectomy
Total excision of Parathyroids, and re-implantation of parathyroid.
Patient in supine position.
Collar incision at a lower neck crease; which was predetermined preoperatively.
The platysma is divided at a higher level than the skin. The flaps of the skin
and superficial fascia as well as the platysma and then reflected upwards
to the level of the thyroid cartilage, and downwards to the sternum.
The anterior jugular veins needed no division, but they were retracted laterally.
Incision of the deep fascia in the midline.
Retraction of the infrahyoid muscle and the fascial sheath laterally.
Division of the pre-tracheal fascia covering the thyroid gland.
Now the left lobe is retracted medially to expose the lateral surface of the lobe
and the upper pole of the gland is delivered out to tie off the vascular pedicle comprising
the superior thyroid vessels. The ties were applied very close to
the gland to avoid possible injury to the external laryngeal nerve.
Ties to branches of inferior thyroid artery were applied; but all ties were plicated well
away from the gland to prevent injury to the recurrent laryngeal nerve.
The left lobe is then cut and followed to remove the isthmus also.
Complete haemostasis is obtained by Fine ligatures, we avoided to use diathermy coagulation.
The left lobe has a bit of retrosternal extension,
and that required mobilization to free its intrathoracic extension.
Attention is now paid to the Right lobe of thyroid, repeating the same steps as in left lobe.
Non-absorbable ties to the Superior thyroid vessels; followed by ties to branches of inferior thyroid vessels.
A haemostatic continuous absorbable suture in the isthmus to control haemorrhage,
also with the Harmonic® scalpel.
Suction drainage is placed at the thyroid bed, and the tube was secured by silk suture.
Closure of the deep fascia, and platysma using Vicryl sutures.
Suturing of the skin using 6/0 Ethilon.