Otolaryngology Coding Alert

Reader Questions:

Include RT/LT - Not 50 - With 60212

Question: My physician performed surgery on both the right and the left lobes. The CPT® book says code 60210 is a unilateral procedure. Can you please clarify whether we can only bill 60210 one time regardless of whether just the right, just the left, or both left and right lobes are addressed?

Connecticut Subscriber 

Answer:  A better option as a starting point might be code 60212 (Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy), which specifies a unilateral procedure. You shouldn’t report 60212 with modifier 50 (Bilateral procedure) when your surgeon addresses both lobes. Instead, append modifier RT (Right side) and/or LT (Left side) to explain the situation. 

If the payer denies 60212, refile the claim with 60210 (Partial thyroid lobectomy, unilateral; with or without isthmusectomy) and modifiers RT and LT. A last resort would be to append modifier LT to your first listing of the procedure code (60210 or 60212) and modifiers RT and 59 (Distinct procedural service) to the second line with the procedure code.

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