Wiki CPT 60252 versus 60254

[vanessa01]

Hi All,
I need help recently getting back into general surgery coding and I am stumped on it this one- I posted this question on the general surgery forum with no reply and thought I would try on here
Dr. states he performed a total thyroidectomy with central compartment cervical node dissection
My initial thought was its a 60252 but the surgeon is stating that a central node dissection is a "radical" node dissection of that compartment so he thinks its 60254-
Please if anyone has any advice or references on this
Thanks,
Vanessa, CPC

 

[nsteinhauser]

Does the op note give you any more info. than 'central compartment cervical node dissection'?
This is from an "Otolaryngology Coding Alert" Jan 2012:

Suppose your otolaryngologist removes both thyroid lobes with the isthmus and
pyramid lobe tissue. He also identifies and excises all enlarged lymph nodes. The
malignancy has not spread significantly, so the otolaryngologist excises only a few
selected lymph nodes. As a result, he performs a thyroidectomy with limited neck
dissection. What CPT code(s) should you report, and should you report a separate
code for the dissection?
Answer 1: You should report only 60252 (Thyroidectomy, total or subtotal for
malignancy; with limited neck dissection). You should not report a separate code
for the dissection. This code includes reimbursement for the thyroidectomy and the
limited dissection.
What if the physician states in the operative note that she performed a “central neck
dissection?” What would you code in this situation?
Answer 2: A central neck dissection is similar to the example above and
represents a limited neck dissection, not a radical neck nor a modified radical
neck dissection. So, if it is stated that a central neck dissection is performed with a
total thyroidectomy, you would report 60252 (Thyroidectomy, total or subtotal for
malignancy; with limited neck dissection).

So based on the above, I'd choose the 60252. Hope this helps.