# Tracheostomy w/ division of thyroid isthmus



## Robin R (Mar 12, 2010)

A surgeon is performing a tracheostomy with division of thyroid isthmus.

Is there an additional code that I can pick up along with 31600?


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## mjewett (Mar 12, 2010)

The explanation for code 31600 per the General Surgery 2010 Coding Companion, by Ingenix.  "The physician makes a horizontal neck incision and dissects the muscles to expose the trachea. The thyroid isthmus is cut if necessary."  

So I would say division of the isthmus is not separately billable.


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## Robin R (Mar 15, 2010)

Thanks so much!

This doctor was being a lot more descriptive than the others & I felt like I was leaving something off.

I have another question about trachs you might know the answer to.

Say a doctor describes on one OP note that they performed an emergency tracheostomy either in the ER or at the patient's bedside - CPT 31605.  Then, the patient is taken to the OR & on another OP note the doctor states that they performed an exploratory laparototomy & converts the cricothyroidotomy to a tracheostomy.  How would you code this scenerio?

Thanks again for your help!


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## mjewett (Mar 15, 2010)

My thought is use code 31600-58 for the second surgery. It sounds like the doctor intended the first surgery to be temporary, and then planned to create a more permanant trach later.  The staged modifier (58) should work.


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## Robin R (Mar 15, 2010)

Thanks for replying Melissa, you've been a big help!


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