General Surgery Coding Alert

Question: The surgeon performed a "completion thyroidectomy." Another physician had previously performed a left lobectomy with biopsy of right lobe. Should I use 60260 or 60220? The pathology report notes that the biopsy "consists of a 20-gram partial thyroidectomy specimen." How did a biopsy become a partial thyroidectomy?

Alabama Subscriber

Answer: The correct code is 60260 (Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid), not 60220 (Total thyroid lobectomy, unilateral; with or without isthmusectomy). The fact that another surgeon performed the original thyroidectomy is not important because the code descriptor refers to "removal of all remaining thyroid tissue following previous removal of thyroid" without referring to the surgeon who performs either procedure. The second surgeon completed the thyroidectomy by removing the rest of the right lobe.

As to the second question, it would be interesting to know how the first surgeon coded the biopsy of the right lobe. Use 60100* (Biopsy thyroid, percutaneous core needle) only for needle core biopsies. Any other biopsy that involves taking a larger sample, such as a wedge of tumor, should not be considered a biopsy, a cyst or an adenoma; instead, it should be reported as 60210 (Partial thyroid lobectomy, unilateral; with or without isthmu-sectomy).

Note: The "partial thyroidectomy" the lab describes in the pathology report was most likely a partial lobectomy.