CPT® Code 60661

1. Indications

The procedure described by CPT® Code 60661 is indicated for patients presenting with symptomatic thyroid nodule(s) that may be causing dysphagia due to benign enlargement of the thyroid tissue. The following conditions may warrant the use of this procedure:

• Dysphagia - Difficulty swallowing caused by the presence of enlarged thyroid tissue.
• Benign Thyroid Nodules - Non-cancerous growths in the thyroid that may lead to discomfort or functional impairment.
• Enlarged Thyroid Gland - A condition where the thyroid gland is enlarged, potentially leading to pressure symptoms.

2. Procedure

The procedure for CPT® Code 60661 involves several key steps to ensure effective ablation of the thyroid nodule(s):

• Patient Positioning - The patient is positioned with the neck extended and rotated obliquely to facilitate optimal visualization of the target nodule(s) using ultrasound imaging.
• Administration of Local Anesthetic - A local anesthetic is injected subcutaneously at the site where the ablation will occur, ensuring that the patient experiences minimal discomfort during the procedure.
• Insertion of the Ablation Probe - A needle-like ablation probe is carefully advanced into the first target lesion, penetrating deep into the tissue to reach the nodule.
• Radiofrequency Energy Application - The tip of the radiofrequency probe 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.
• Continuous Ultrasound Guidance - Throughout the procedure, ultrasound imaging is used continuously to monitor the ablation process, ensuring accurate targeting and minimizing the risk of damage to surrounding tissues.
• Sequential Ablation of Lesions - The probe is repositioned as needed to treat additional areas of the nodule, ablating small overlapping sections until the entire lesion is addressed. A small margin of approximately 5 mm is intentionally left untreated to protect adjacent healthy tissue.
• Post-Ablation Ultrasound - After the ablation is completed, a follow-up ultrasound is performed to verify that the treatment was successful and that no other tissues outside the nodule's capsule were affected.

3. Post-Procedure

Following the ablation procedure coded under CPT® Code 60661, patients may be monitored for any immediate post-procedural complications. It is common for patients to experience some mild discomfort or swelling at the ablation site, which typically resolves within a few days. The follow-up ultrasound is crucial to confirm the effectiveness of the ablation and to ensure that the nodule has been adequately treated without affecting surrounding structures. Patients may be advised on any necessary follow-up appointments to monitor their recovery and assess the long-term outcomes of the procedure.