ljones88
Networker
Hi all,
Does anyone know if you can still report 60505 (Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach) if the physician uses a cervical approach not a sternal or transthoracic approach? Or would I still report 60500 because of the approach and/or the location of the tissue being in the superior aspect of the mediastinum? The physician removed a parathyroid adenoma from the superior mediastinum.
Op report reads:
The patient was taken to the operating room and placed supine on the operating table. General endotracheal anesthesia was provided by the anesthesia service. A NIMS endotracheal tube was used. Two NIMS grounding electrodes were placed sterilely in the chest wall. TED hose and SCDs were placed on his lower extremities and blood was obtained for baseline intraoperative parathyroid hormone testing. The patient's neck was positioned in an extended fashion and the bed was placed in lounge chair position. His neck was prepped and draped in a sterile fashion and timeout was performed. A 15 blade scalpel was used to make a 4 cm transverse cervical incision. Electrocautery was used to dissect through the platysma. Subplatysmal flaps were raised and the strap muscles divided in the midline. The Strap muscles were dissected free from the underlying left thyroid lobe. The lobe was retracted medially, the carotid sheath was opened, and function of the recurrent laryngeal nerve was confirmed by NIMS probe stimulation of the vagus nerve. The paratracheal space was examined and an adenomatous appearing parathyroid gland was identified lateral to the esophagus in the superior mediastinum. The left superior pole parathyroid adenoma was dissected off of the underlying vertebral body and its blood supply was divided with the Harmonic Scalpel. Blood was obtained for intraoperative parathyroid hormone testing at 5, 10, and 20 minutes post excision of the parathyroid adenoma. Valsalva maneuver x 2 was performed. Hemostasis was assured.
Does anyone know if you can still report 60505 (Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach) if the physician uses a cervical approach not a sternal or transthoracic approach? Or would I still report 60500 because of the approach and/or the location of the tissue being in the superior aspect of the mediastinum? The physician removed a parathyroid adenoma from the superior mediastinum.
Op report reads:
The patient was taken to the operating room and placed supine on the operating table. General endotracheal anesthesia was provided by the anesthesia service. A NIMS endotracheal tube was used. Two NIMS grounding electrodes were placed sterilely in the chest wall. TED hose and SCDs were placed on his lower extremities and blood was obtained for baseline intraoperative parathyroid hormone testing. The patient's neck was positioned in an extended fashion and the bed was placed in lounge chair position. His neck was prepped and draped in a sterile fashion and timeout was performed. A 15 blade scalpel was used to make a 4 cm transverse cervical incision. Electrocautery was used to dissect through the platysma. Subplatysmal flaps were raised and the strap muscles divided in the midline. The Strap muscles were dissected free from the underlying left thyroid lobe. The lobe was retracted medially, the carotid sheath was opened, and function of the recurrent laryngeal nerve was confirmed by NIMS probe stimulation of the vagus nerve. The paratracheal space was examined and an adenomatous appearing parathyroid gland was identified lateral to the esophagus in the superior mediastinum. The left superior pole parathyroid adenoma was dissected off of the underlying vertebral body and its blood supply was divided with the Harmonic Scalpel. Blood was obtained for intraoperative parathyroid hormone testing at 5, 10, and 20 minutes post excision of the parathyroid adenoma. Valsalva maneuver x 2 was performed. Hemostasis was assured.