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The procedure described by CPT® Code 60260 refers to a thyroidectomy, specifically the surgical removal of all remaining thyroid tissue after a previous partial thyroidectomy. This operation is typically indicated when there is a need to eliminate any residual thyroid tissue that may be causing complications or is at risk of becoming problematic. The procedure begins with the patient positioned to extend the neck, allowing for optimal access to the thyroid gland. A transverse incision is made in the skin over the thyroid, usually aligned with the natural creases of the neck to minimize scarring. The incision is deepened through the subcutaneous tissue and the platysma muscle to expose the remaining thyroid tissue. The surgical approach may vary based on the volume of thyroid tissue that remains. Key anatomical structures, such as the middle thyroid vein, recurrent laryngeal nerve, and parathyroid glands, are carefully identified and preserved to prevent complications. The procedure involves ligating blood vessels associated with the thyroid, dividing the Berry ligament, and elevating the isthmus of the thyroid off the trachea before the final removal of the remaining thyroid tissue. After the procedure, the surgical wounds are meticulously repaired, and suction drains may be placed as necessary to manage any postoperative fluid accumulation.
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The procedure associated with CPT® Code 60260 is indicated for patients who have undergone a previous partial thyroidectomy and require the removal of any remaining thyroid tissue. This may be necessary in cases where there is a risk of thyroid-related complications, such as hyperthyroidism, or when there is a concern regarding the potential for malignancy in the residual thyroid tissue. The decision to perform this procedure is typically based on clinical evaluations and imaging studies that suggest the presence of remaining thyroid tissue that could lead to adverse health outcomes.
The surgical procedure for CPT® Code 60260 involves several critical steps to ensure the safe and effective removal of the remaining thyroid tissue. Initially, the patient is positioned with the neck extended to provide optimal access to the thyroid gland. A transverse skin incision is made over the thyroid, typically in one of the natural creases of the neck to minimize visible scarring. This incision is then deepened through the subcutaneous tissue and the platysma muscle, allowing the surgeon to expose the remaining thyroid tissue. The specific approach may vary depending on the amount of residual thyroid tissue present.
Once the remaining tissue is accessible, the middle thyroid vein is identified and ligated to control blood flow. Careful attention is given to the recurrent laryngeal nerve and parathyroid glands, which are critical structures that must be preserved to prevent postoperative complications. The surgeon then identifies and ligates the blood vessels in the superior pole of the thyroid, followed by the ligation of the terminal branches of the inferior thyroid artery. This step is crucial for ensuring hemostasis during the procedure.
After managing the blood supply, the Berry ligament is divided, which allows for the elevation of the isthmus of the thyroid off the trachea. This maneuver facilitates the complete removal of the remaining thyroid tissue. Once the tissue is excised, the surgical wounds are repaired meticulously to promote optimal healing. Depending on the extent of the surgery and the presence of any fluid accumulation, suction drains may be placed to aid in postoperative recovery.
After the completion of the thyroidectomy procedure, patients are typically monitored for any immediate postoperative complications. Careful observation is essential to ensure that there are no issues related to bleeding, infection, or damage to surrounding structures, particularly the recurrent laryngeal nerve and parathyroid glands. Patients may experience some discomfort and swelling in the neck area, which is expected following surgery. Pain management strategies will be implemented as needed. The surgical site will be assessed for proper healing, and any drains placed during the procedure will be monitored and managed accordingly. Follow-up appointments will be scheduled to evaluate the patient's recovery and to check for any signs of complications or the need for further treatment.
| Short Descr | REPEAT THYROID SURGERY | Medium Descr | THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL | Long Descr | Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 10 - Thyroidectomy, partial or complete |
This is a primary code that can be used with these additional add-on codes.
| 60512 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Parathyroid autotransplantation (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AI | Principal physician of record | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service |
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