Nicole, Based on what you provided, this is how I would code a total thyroidectomy w/bilateral nerve preservation & monitoring w/re-implantation of parathyroid gland:
60240 - Total Thyroidectomy
60512 - Parathyroid autotransplantation (add on code, no modifier)
95865-26 - Needle electromyography -Larynx
95920-26 - Intraoperative neurophysiology testing, per hour (add on code,
no other modifier)
It is important with regards to the nerve monitoring that your surgeon includes this in their operative report and that they indicate how many hours the nerve monitoring was performed, 95920 is billed per hour, so if it took 4 hours, we bill 4 units. There is controversy with regards to billing intraoperative nerve monitoring, there are some insurance carriers, Medicare included, that will not pay. The Academy of Otolaryngology has a coding article on their website, you may want to take a look.
If anyone else has more info or other opinions, please, it's always good to get feed back.
Hope this helps,
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