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Parathyroid autotransplantation is a surgical procedure performed when all parathyroid glands need to be removed, typically due to conditions such as hyperparathyroidism caused by parathyroid adenomas. The parathyroid glands, which are four small glands located behind the thyroid gland, play a crucial role in regulating calcium levels in the blood by secreting parathyroid hormone. When blood calcium levels drop, these glands release the hormone to restore balance, and they cease secretion when levels normalize. In cases where one or more parathyroid glands are enlarged, indicating potential adenomas, a surgical exploration is conducted to excise the affected glands. If the surgical procedure necessitates the removal of all four parathyroid glands, the surgeon will perform a parathyroid autotransplantation to preserve parathyroid function. This involves taking small pieces of normal parathyroid tissue and implanting them into a muscle, such as the sternocleidomastoid muscle or a muscle in the forearm, to maintain hormonal regulation of calcium levels post-surgery. The procedure is reported separately in addition to the primary surgical procedure code for the exploration and excision of the parathyroid glands.
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Parathyroid autotransplantation is indicated in the following scenarios:
The procedure for parathyroid autotransplantation involves several critical steps:
After the parathyroid autotransplantation, patients may require monitoring for calcium levels to ensure that the transplanted tissue is functioning properly. Recovery may involve managing any discomfort from the surgical site and monitoring for potential complications. Follow-up appointments are essential to assess the success of the autotransplantation and to check for any signs of hypoparathyroidism, which can occur if the remaining parathyroid tissue is insufficient to regulate calcium levels adequately.
| Short Descr | AUTOTRANSPLANT PARATHYROID | Medium Descr | PARATHYROID AUTOTRANSPLANTATION ADD-ON | Long Descr | Parathyroid autotransplantation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | 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 an add-on code that must be used in conjunction with one of these primary codes.
| 60212 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy | 60220 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code Total thyroid lobectomy, unilateral; with or without isthmusectomy | 60225 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy | 60240 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, total or complete | 60252 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, total or subtotal for malignancy; with limited neck dissection | 60254 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, total or subtotal for malignancy; with radical neck dissection | 60260 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid | 60270 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach | 60271 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Illustration for Code Thyroidectomy, including substernal thyroid; cervical approach | 60500 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting Illustration for Code Parathyroidectomy or exploration of parathyroid(s); | 60502 | MPFS Status: Active Code APC J1 Physician Quality Reporting Illustration for Code Parathyroidectomy or exploration of parathyroid(s); re-exploration | 60505 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach |
| 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 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). | 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 | GW | Service not related to the hospice patient's terminal condition | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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