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The CPT® Code 60505 refers to a surgical procedure known as parathyroidectomy or exploration of the parathyroid glands, specifically when a mediastinal exploration, sternal split, or transthoracic approach is utilized. The parathyroid glands, typically four in number, are small endocrine glands located behind the thyroid gland, with two situated in each lobe at the upper and lower lateral aspects. Their primary function is to regulate calcium levels in the bloodstream by secreting parathyroid hormone (PTH). When blood calcium levels decrease, the parathyroid glands release PTH to elevate these levels, and conversely, they cease secretion when calcium levels normalize. This procedure is indicated when there is an enlargement of one or more parathyroid glands, often due to a parathyroid adenoma, which leads to hyperparathyroidism characterized by excessive production of PTH. During the surgery, a transverse incision is made in the neck over the thyroid gland, allowing access to the parathyroid glands. The surgeon elevates the thyroid to expose the enlarged gland, which is then dissected from surrounding tissues and excised. If other parathyroid glands are found to be enlarged during the procedure, they may also be removed. In cases where all four glands are excised, a parathyroid autotransplantation may be performed, where small pieces of normal parathyroid tissue are implanted into a muscle, typically the sternocleidomastoid or a forearm muscle, to preserve parathyroid function. The use of CPT® Code 60505 is specifically for instances where a more invasive approach, such as a sternal split or transthoracic method, is necessary to access the enlarged parathyroid gland, which may involve dissection and exploration of the mediastinum.
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The procedure described by CPT® Code 60505 is indicated for the following conditions:
The procedure for CPT® Code 60505 involves several critical steps:
Post-procedure care following a parathyroidectomy with mediastinal exploration includes monitoring for complications such as bleeding, infection, or hypoparathyroidism, which can occur if the parathyroid glands are damaged or removed. Patients may experience some discomfort at the incision site, and pain management will be provided as necessary. Follow-up appointments are essential to assess calcium levels and ensure that the remaining parathyroid tissue is functioning adequately. Patients may also require calcium and vitamin D supplementation if they experience low calcium levels after surgery. Overall, the recovery process will vary based on the extent of the surgery and the individual patient's health status.
| Short Descr | EXPLORE PARATHYROID GLANDS | Medium Descr | PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC | Long Descr | Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 12 - Other therapeutic endocrine procedures |
This is a primary code that can be used with these additional add-on codes.
| 32674 | Add-on Code MPFS Status: Active Code APC C Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) | 38746 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) | 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. | 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). | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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