General Surgery Coding Alert

Question: My doctor excised the left upper parathyroid gland by excision, which revealed parathyroid hyperplasia. Then he did a right upper and lower parathyroid gland, which revealed on the right upper parathyroid hyperplasia and for the right lower it revealed papillary thyroid carcinoma. How should I report this procedure? Do I need to use RT/LT?

Louisiana Subscriber

Answer: You should report this procedure using one instance of 60500 (Parathyroidectomy or exploration of parathyroid[s]).

No modifiers: The parathyroids are not really bilateral structures. Therefore, modifiers LT (Left side) and RT (Right side) are not acceptable on this code.

Diagnosis help: You should assign both the cancer diagnosis and the hyperplasia diagnosis when you report this procedure. Use 194.1 (Malignant neoplasm of parathyroid gland) for the cancer and 237.4 (Neoplasm of uncertain behavior of other and unspecified endocrine glands) for the hyperplasia.