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tracheostomy and throidotomy

  1. #1
    Default tracheostomy and throidotomy
    Medical Coding Books
    I have a physician who did a tracheostomy and thyroidotomy, i know the trach cpt would be 31600 unsure about thyroid.

  2. #2
    Thumbs up Thyroidectomy Code
    You may please check in the Surgery Chapter/Endocrine system/Thyroid gland. There the code for thyroidectomy starts from 60200(isthmus) to 60270depending on extend, including the approach.

    I hope this helped you


  3. Default
    OK, you need to provide a little more info, I have never heard of a "thyroidotomy", was this a "thyroidectomy"? or did your surgeon perform the tracheotomy and divide the isthmus (tissue that connects the thyroid lobes) during the procedure? Your op note would be helpful.

    CT ENT

  4. #4
    OPERATION: Tracheostomy and Thyroidotomy

    After suitable endotracheal anesthesia had been accomplished per indwelling endotracheal tube, an attempt was made at placing a PEG device; however, this was not possible because I could never see the indentation on the stomach wall in order to find an adequate location to place the PEG tube, so this was abandoned. The neck was the prepped and draped in the usual manner. a low collar incision was made 2cm plus or minus from the suprasternal notch apex and extended down to the strap muscles. Left and right external jugular veins were encountered that were very large. These were approximately 1.2cm in diameter. These were ligated with 2-0 silk sutures and divided. Next, the strap muscles were divided and retracted laterally. The thyroid gland was quite massive. It overlaid the trachea. It was necessary to take down the central portion of the thyroid gland and divide it in the center between 2-0 suture ligatures of silk. After this was done, the trachea came into view at approximately the second to third tracheal ring. Traction sutures of 2-0 silk were placed. The thyroidotomy was completed at this point and the incision into the trachea was carried out in an H type fashion. Next, the endotracheal tube was withdrawn to the point where a lubricated #8 extra long tracheostomy tube was placed successfully and connected to the anesthesia circuit. There was good gas exchange present and good entitled c02. The wound was then closed with vertical mattress sutures and horizontal mattress suture of 2-0 silk.

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