Results 1 to 7 of 7

Your suggestion on this surgery

  1. Default Your suggestion on this surgery
    Exam Training Packages
    I am asking for your input on how to code this surgery. Procedure done: Total Thyroidectomy with bilateral recurrent laryngeal nerve dissection and preservation. And Reimplantation of left superior parathyroid gland in the right sternocleidomastiod muscle.

    I coded the 60240 for the total thyroidectomy and 95865 for the nerve monitoring (do we use modifier 26 with that?) What do we need to use for the reimplantation?

    Thanks for all of your help!

  2. Default
    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,

    ENT CT
    Last edited by jackjones62; 04-16-2009 at 09:12 PM.

  3. #3
    Default Your suggestion on this surgery
    Hi Nicole,

    Per CPT coding guidelines, CPT code 95920 cannot be reported by the surgeon and/or assistant surgeon, It can only be reported if the IOM is provided by a physician other then the surgeon either in the OR or remotely.

    Hope this helps,

    Nidhi M.

  4. Default
    I agree with the last posting, the surgeon, assist at surgery and or anesthesiologist cannot bill for the monitoring, must be done by a tech or qualified health provider not involved in the surgery. Also the codes have changed from 95920 to 95940.

    A. Walker

  5. #5
    Eugene, OR
    Can't find where the assistant surgeon can't bill for intraoperative monitoring - it's not spelled out in the CPT manual - only mentions the surgeon or the anesthesiologist. Is there another reference that specifically notes that? Thanks.

  6. #6
    Stuart Sailfish Chapter
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

  7. #7
    Eugene, OR
    Thank you, Candy!!

Similar Threads

  1. Suggestion/advice please
    By aarthys11 in forum Employment General Discussion
    Replies: 2
    Last Post: 07-08-2014, 09:40 AM
  2. any dx suggestion? help please
    By micki127 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 02-10-2014, 01:14 PM
  3. Need suggestion....
    By prem_ponnuru in forum Medical Coding General Discussion
    Replies: 7
    Last Post: 10-03-2008, 09:33 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.

Get OurFREE2017SalarySurvey.

We'll email you a link to our 2017 Healthcare Salary Survey when it is available so you can see your earning potential.