Total Thyroidectomy

Ravikirann

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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.
 
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