Otolaryngology Coding Alert

Question: I know that the parathyroidectomy and thyroidectomy are incidental to each other. However, as they are two different procedures, would it be acceptable to report both on a claim if we append modifier 22 to the parathyroid procedure?

Nevada Subscriber

Answer: If doing both a parathyroidectomy and a thyroidectomy represented a significant amount of extra work over doing the primary procedure (the thyroidectomy), you can consider adding modifier 22 for increased service to the thyroidectomy code. Even though a parathyroidectomy may have more RVUs than a thyroidectomy, depending on which specific thyroidectomy is performed, the modifier would not be added to the parathyroidectomy since it is the Column 2 code in the bundle under the Correct Coding Initiative (CCI). Keep in mind, “significant amounts of extra work” means that the surgery encompassed more than 25 percent more work and risk than found with the average thyroidectomy case.