Inpatient Facility Coding & Compliance Alert

Question: I’ve always considered 60271 to represent total removal, along with the substernal thyroid excision. However, this interpretation conflicts with the note associated with 60240 which states, “For thyroidectomy, subtotal or partial, use 60271.” Please guide us in choosing the correct code. 

Illinois Subscriber 

Answer: There is some support for using 60271 (Thyroidectomy, including substernal thyroid; cervical approach) for complete removal, as you suggest. For example, Medicare pays more for 60271 than for 60240 (Thyroidectomy, total or complete), indicating that it’s considered to be a more complex procedure. Also remember that Correct Coding Initiative (CCI) edits bundle 60240 into 60271. That means if a physician reports both codes, Medicare will pay for only 60271 (again indicating that this is the more complex procedure). 

Based on this rationale, 60271 should be appropriate for the cervical approach for removing thyroid tissue including the substernal thyroid, whether it’s total or subtotal.