ShiketheiaThornton
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I have a patient who is having a right thyroid lobectomy done. Do I code for a total or partial
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Lobectomy inpatient surgery
- Thread starter ShiketheiaThornton
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Ruth Sheets
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This is one of the topics that is covered in the Blitz videos. The Blitz videos not only cover Bubble and Highlighting of the CPT manual, but topics that are often confusing to new coders.
Because it is the right thyroid lobe that is getting removed, it is a total thyroid lobectomy, 60220. I know this because of the notes I made in my CPT manual while listening to the Blitz videos.
Because it is the right thyroid lobe that is getting removed, it is a total thyroid lobectomy, 60220. I know this because of the notes I made in my CPT manual while listening to the Blitz videos.
Ruth Sheets
CCO Moderator
Staff member
Administrator
Moderator
Blitzer
PBC Student (CPC®)
CCO Club Member
CCO Support Staff
MTA Student
ICD-10-CM Student
PPM Student (CPPM®)
FBC Student (CPC-H®)
Summarizing from a recent Q&A Webinar:
Laureen: "Think of a butterfly and there’s a picture in CPT that if you… you can kind of visualize it and it does look like a butterfly, like the 2 wings on either side and then that middle little on the thyroid. It’s called the isthmus.
So when you look at the codes, if you think of the butterfly… because some of them will say they did…one lobe. Some will say they did part of one lobe and part of another lobe so let’s go through that. Now that you have the visual of a butterfly in mind with the isthmus in the middle, the first two codes are a biopsy and then an excision of an adenoma or cyst. But this is where they start for the thyroidectomy code. 60210 is partial thyroid lobectomy, unilateral and this is with or without the isthmus so with or without the middle portion.
So this is actually supposed to look like ¼ so ¼ of the butterfly is being removed because there are 2 lobes, a right and left lobe. So they’re doing a partial lobectomy on one side. So that’s why I think of it as ¼ of the butterfly. ''
[Ed. Note: By visualizing the thyroid to look like a butterfly you can easily distinguish how much of the thyroid is being removed… and choose the proper code, accordingly.]
Now 60212 says with the contralateral, which means opposite side, subtotal lobectomy including the isthmus. So think of that as half the butterfly. It’s not one whole lobe. It could be the upper of the right and the lower of the left or the upper of the right and the upper of the left. You get the idea but basically, half the butterfly is being removed.
60220 is a total thyroid lobectomy, unilateral. So that would be the answer for your question here, having the right thyroid lobectomy done. If they’re removing the whole lobe, that’s what’s you’re going to use, 60220. And so that’s half the butterfly but it’s one side, right or left. And again, it’s with or without the isthmus. You don’t code that separate if they do it.
More examples are on the October 2012 Q&A Webinar video replay and transcript available through the CCO Club.
Laureen: "Think of a butterfly and there’s a picture in CPT that if you… you can kind of visualize it and it does look like a butterfly, like the 2 wings on either side and then that middle little on the thyroid. It’s called the isthmus.
So when you look at the codes, if you think of the butterfly… because some of them will say they did…one lobe. Some will say they did part of one lobe and part of another lobe so let’s go through that. Now that you have the visual of a butterfly in mind with the isthmus in the middle, the first two codes are a biopsy and then an excision of an adenoma or cyst. But this is where they start for the thyroidectomy code. 60210 is partial thyroid lobectomy, unilateral and this is with or without the isthmus so with or without the middle portion.
So this is actually supposed to look like ¼ so ¼ of the butterfly is being removed because there are 2 lobes, a right and left lobe. So they’re doing a partial lobectomy on one side. So that’s why I think of it as ¼ of the butterfly. ''
[Ed. Note: By visualizing the thyroid to look like a butterfly you can easily distinguish how much of the thyroid is being removed… and choose the proper code, accordingly.]
Now 60212 says with the contralateral, which means opposite side, subtotal lobectomy including the isthmus. So think of that as half the butterfly. It’s not one whole lobe. It could be the upper of the right and the lower of the left or the upper of the right and the upper of the left. You get the idea but basically, half the butterfly is being removed.
60220 is a total thyroid lobectomy, unilateral. So that would be the answer for your question here, having the right thyroid lobectomy done. If they’re removing the whole lobe, that’s what’s you’re going to use, 60220. And so that’s half the butterfly but it’s one side, right or left. And again, it’s with or without the isthmus. You don’t code that separate if they do it.
More examples are on the October 2012 Q&A Webinar video replay and transcript available through the CCO Club.