General Surgery Coding Alert

Question: Our surgeon performed a left substernal thyroid lobectomy by cervical approach. Should we report 60271, which lists substernal thyroid in the code descriptor?

Oklahoma Subscriber

Answer: No, code 60271 (Thyroidectomy, including substernal thyroid; cervical approach) is appropriate only for a total thyroidectomy, not a thyroid lobectomy that removes only part of the thyroid.

You should instead turn to the appropriate code for thyroid lobectomy, 60220 (Total thyroid lobectomy, unilateral; with or without isthmusectomy).

Here’s why: Code 60220 does not specify nor restrict the approach to cervical, and it is the only open thyroid excision code for removal of one complete thyroid lobe. Because the code does not include the substernal component, you may report 60220 with modifier 22 (Increased procedural services).