CPT® Code 60660

1. Indications

The procedure described by CPT® Code 60660 is indicated for patients experiencing symptoms related to thyroid nodules, particularly those that are benign and causing dysphagia, or difficulty swallowing. The presence of enlarged thyroid tissue can lead to discomfort and complications, making this ablation procedure a suitable option for symptomatic relief.

• Dysphagia Difficulty swallowing due to the presence of enlarged thyroid tissue or nodules.
• Benign thyroid nodules Non-cancerous growths in the thyroid that may cause symptoms or discomfort.

2. Procedure

The procedure begins with the patient being positioned with their neck extended and rotated obliquely to facilitate the identification of the target nodule(s) using ultrasound imaging. This positioning is crucial for accurate targeting and effective treatment. Once the nodule is located, a local anesthetic is injected subcutaneously at the site where the ablation will occur, ensuring that the patient experiences minimal discomfort during the procedure.

• Step 1: The ultrasound is utilized to locate the target nodule(s) accurately, allowing the physician to visualize the area that requires treatment.
• Step 2: A needle-like ablation probe is then advanced into the first target lesion, penetrating deep into the tissue to reach the nodule.
• Step 3: The radiofrequency probe tip emits radio waves that generate heat, effectively destroying the cells within the nodule. This process leads to the shrinkage of the nodule as it is converted into scar tissue.
• Step 4: Continuous ultrasound guidance is maintained throughout the procedure to monitor the treatment area and ensure that the ablation is performed accurately.
• Step 5: The probe is left in place until the surrounding tissue reflects more echoes than normal, indicating that the ablation is effective and the tissue appears brighter on the ultrasound.
• Step 6: The probe is then repositioned to treat additional areas, working its way up to more superficial tissue and ablating small overlapping areas until the entire lesion is adequately treated.
• Step 7: A small margin of approximately 5 mm is intentionally left untreated to avoid damaging adjacent healthy tissue.
• Step 8: After the ablation is completed, a post-ablation ultrasound is performed to confirm that the treatment is complete and that no other tissues outside the capsule of the nodule were penetrated during the procedure.

3. Post-Procedure

Following the ablation procedure, patients may be monitored for any immediate complications or side effects. The post-ablation ultrasound is a critical step to ensure that the treatment was successful and that the surrounding tissues remain intact. Patients may experience some discomfort at the ablation site, which can typically be managed with over-the-counter pain relief. Recovery time may vary, but many patients can resume normal activities shortly after the procedure. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor the thyroid function and any potential changes in the size of the nodule(s).