Wiki Parathyroidectomy

[mentsa]

One of our physicians recently did a left thyroid lobectomy on a patient. During the surgery it was found that the parathyroid was enlarged. He then did a left superior parathyroidectomy and sent half to pathology. It was found to be healthy but enlarged to twice the size as normal. At this point he re-implanted the other half of the parathyroid. Our question is, when billing for this procedure, we know to bill for the thyroid lobectomy but we are unsure of how to bill for the parathyroid. Would we bill for a parathyroidectomy alone or would we bill for the reimplantation of the parathyroid also or is there a bundle code for this procedure? Any input on this is greatly appreciated.

 

[b.cobuzzi]

The parathyroidectomy on the same side as the thyroidectomy is bundled. But the reimplantation of the parathyroid is billable in addition to the thyroidectomy, The reimplantation is coded +60512 Parathyroid autotransplantation (List separately in addition to code for primary procedure). This is an add on procedure and should not have it’s fee reduced for multiple procedures.

 

[lbarog101@gmail.com]

Hi Barbara, on your answer above, how can a parathyroidectomy be on the left or right? I checked encoder and we can't use modifiers LT or RT on CPT 60500. So if they did the para and thyroid on opposite sides, how can we show that on a claim?

 

[b.cobuzzi]

lbarog101, there are actually 4 parathyroid glands, 2 on the left and 2 on the right. The surgeon must document that the parathyroid exploration or resection was on the countralateral side from the thyroid lobe removed or give which side the thyroid lobe was resected and which side the parathyroid exploration/resection was performed, showing it was on the countralateral side, and then you can use the XS or if the payer does not recognize the X modifiers, the 59 modifier and code both the thyroid lobectomy and the parathyroidectomy. Although the LT and RT modifiers are not applicable to 60500, the 59 and XS are available modifiers. I have attached a picture for you to reference what I am talking about.