Otolaryngology Coding Alert

Question: My surgeon believes there should be a specific code for pediatric thyroidectomy and that it should have a much higher allowable since children’s veins and blood vessels are so much smaller. Is there a specific CPT^® code for a pediatric thyroidectomy?

Codify Subscriber

Answer:  CPT^® does not currently include a procedure code specifically for pediatric thyroidectomy. Your best option is to report the thyroidectomy code (range 60210-60271) and append modifier 22 (Increased procedural services) to recognize the additional work associated with the surgery on a child instead of an adult. The operative note should reflect the increased complexity of the surgery when compared to a standard adult surgery. Include a letter from the physician explaining how the smaller anatomy complicates the procedure, thus justifying modifier 22 and increase your fee.  If you are not paid your increased fee submit an appeal with the operative note and point out the 22 modifier and explain how the smaller structures have complicated the surgery and refer to the documentation.