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Tracheostomy w/ division of thyroid isthmus

  1. #1
    Location
    Pittsburgh Central
    Posts
    75
    Question Tracheostomy w/ division of thyroid isthmus
    Medical Coding Books
    A surgeon is performing a tracheostomy with division of thyroid isthmus.

    Is there an additional code that I can pick up along with 31600?

  2. #2
    Location
    Johnson City
    Posts
    202
    Default
    The explanation for code 31600 per the General Surgery 2010 Coding Companion, by Ingenix. "The physician makes a horizontal neck incision and dissects the muscles to expose the trachea. The thyroid isthmus is cut if necessary."

    So I would say division of the isthmus is not separately billable.
    Melissa Jewett, CPC

  3. #3
    Location
    Pittsburgh Central
    Posts
    75
    Default
    Thanks so much!

    This doctor was being a lot more descriptive than the others & I felt like I was leaving something off.

    I have another question about trachs you might know the answer to.

    Say a doctor describes on one OP note that they performed an emergency tracheostomy either in the ER or at the patient's bedside - CPT 31605. Then, the patient is taken to the OR & on another OP note the doctor states that they performed an exploratory laparototomy & converts the cricothyroidotomy to a tracheostomy. How would you code this scenerio?

    Thanks again for your help!

  4. #4
    Location
    Johnson City
    Posts
    202
    Default
    My thought is use code 31600-58 for the second surgery. It sounds like the doctor intended the first surgery to be temporary, and then planned to create a more permanant trach later. The staged modifier (58) should work.
    Melissa Jewett, CPC

  5. #5
    Location
    Pittsburgh Central
    Posts
    75
    Default
    Thanks for replying Melissa, you've been a big help!

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