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60500 and 60240 Bundles

Mary Leidy

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Local Chapter Officer
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MOCA Omaha
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Can someone help me explain to my physician why CPT 60500 bundles into 60240. He is questioning, b/c the parathyroid exploration and excision was indicated for a clinical indication distinct from the indication related to thyroidectomy(parathyroid adenoma and hyperparathyroidism for 60500 and multinodular goiter for 60240). Thank you! Asking for a friend and the physician is questioning....
 
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I found this information using the: NATIONAL CORRECT CODING INITIATIVE’S (NCCI)
GENERAL CORRESPONDENCE LANGUAGE AND SECTION-SPECIFIC EXAMPLES (FOR NCCI PROCEDURE TO PROCEDURE (PTP) EDITS AND MEDICALLY UNLIKELY EDITS (MUE)) on the CMS website

https://www.cms.gov/Medicare/Coding...loads/ncci_correspondence_language_manual.pdf


CPT code 60240 describes a total or complete thyroidectomy. CPT code 60500 describes a parathyroidectomy or exploration of parathyroid(s).
The exploration of parathyroid glands with or without parathyroidectomy (CPT code 60500) is standard surgical practice when performing a complete thyroidectomy (CPT code 60240). Therefore, CPT code 60500 is bundled into CPT code 60240.
 

Stacey Walden

Contributor
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60500 & 60240 bundling

I have reviewed the Correct Coding Initiative which indicates that 60500 will bundle in 60240 however, this document is dated 2014.

Does anyone have any additional, more recent information regarding the bundling of these two codes? My physician has indicated that these should not bundle because the patient had two separate problems (hyperparathyroidism and they discovered a thyroid malignancy during surgery). We are attempting appeal but I cannot find any good documentation to help us.

Thank you!
 

daniel

True Blue
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596
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From CPT assistant: When a thyroidectomy is performed for malignancy, the parathyroid glands may also be removed, and because this would be considered incidental, the parathyroidectomy (60500) would not be separately reported. For example, if a left thyroidectomy was incidental to a left parathyroid biopsy and resection, then the work is considered inclusive of the parathyroid gland removal described by code 60500, as this code refers to all four parathyroid glands and is not reported as a unilateral procedure. Therefore, only code 60500 would be reported. However, if the thyroid lobectomy was performed for an independent diagnosis, then code 60220 would also be reported with modifier 59, Distinct Procedural Service, appended.
 
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