How To Use CPT Code 60220

CPT 60220 is a surgical procedure code for total thyroid lobectomy, unilateral, with or without isthmusectomy. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 60220 procedures.

1. What is CPT 60220?

CPT 60220 is a procedure code used to describe the complete surgical removal of one of the two lobes of the thyroid gland, with or without the removal of the isthmus, the tissue connecting the two lobes. This procedure is primarily performed to remove malignant cancerous thyroid tissue.

2. 60220 CPT code description

The official description of CPT code 60220 is: “Total thyroid lobectomy, unilateral; with or without isthmusectomy.”

3. Procedure

The 60220 procedure involves the following steps:

1. After the patient is appropriately prepped and anesthetized, the provider makes a standard neck incision about 3–5 inches horizontally in the lower part of the front of the neck just below the voice box.
2. The provider separates the skin into upper and lower flaps and divides the overlying muscles.
3. He takes care to avoid injury to the adjacent recurrent laryngeal nerve that innervates the vocal cord and to the overlying thyroid arteries and veins that provide blood circulation to the thyroid.
4. The provider then removes one complete lobe of the thyroid gland. He may or may not remove the isthmus as indicated.
5. After achieving hemostasis, which is stoppage of bleeding, the provider closes the overlying muscles and skin in layers.

4. Qualifying circumstances

Patients eligible to receive CPT code 60220 services are those diagnosed with malignant cancerous thyroid tissue or other conditions that require the removal of one lobe of the thyroid gland. The decision to perform this procedure is based on the patient’s medical history, physical examination, and diagnostic tests, such as ultrasound, fine-needle aspiration biopsy, or other imaging studies.

5. When to use CPT code 60220

It is appropriate to bill the 60220 CPT code when a provider performs a total thyroid lobectomy, unilateral, with or without isthmusectomy, to remove malignant cancerous thyroid tissue or other conditions requiring the removal of one lobe of the thyroid gland. The procedure should be medically necessary and supported by the patient’s medical history, physical examination, and diagnostic tests.

6. Documentation requirements

To support a claim for CPT 60220, the following information needs to be documented:

• Patient’s medical history, including the diagnosis of malignant cancerous thyroid tissue or other conditions requiring the removal of one lobe of the thyroid gland.
• Physical examination findings, including any palpable thyroid nodules or other abnormalities.
• Diagnostic tests, such as ultrasound, fine-needle aspiration biopsy, or other imaging studies, supporting the need for the procedure.
• Operative report, including a detailed description of the procedure performed, any complications encountered, and the final pathology report.
• Postoperative care and follow-up plan.

7. Billing guidelines

When billing for CPT code 60220, it is essential to follow the specific guidelines and rules set by the payer. Some tips for billing this code include:

• Ensure that the procedure is medically necessary and supported by the patient’s medical history, physical examination, and diagnostic tests.
• Document the procedure in detail, including any complications encountered and the final pathology report.
• Be aware of any additional codes that may apply to the procedure, such as 60500 for parathyroidectomy if performed concurrently with the thyroid lobectomy.
• Choose the appropriate code based on the extent of the gland excised, and be aware of similar codes, such as 60210, 60212, and 60225.

8. Historical information

CPT 60220 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 60220

There are several similar codes to CPT 60220, which differentiate based on the extent of the gland excised and the specific procedure performed. These include:

• CPT 60210: Partial thyroid lobectomy, unilateral; with or without isthmusectomy.
• CPT 60212: Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy.
• CPT 60225: Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy.
• CPT 60240: Thyroidectomy, total or complete.
• CPT 60252: Thyroidectomy, total or complete; with limited neck dissection.

10. Examples

Here are 10 detailed examples of CPT code 60220 procedures:

1. A 45-year-old female with a history of papillary thyroid carcinoma undergoes a total thyroid lobectomy of the right lobe with isthmusectomy.
2. A 55-year-old male with a large, symptomatic goiter undergoes a total thyroid lobectomy of the left lobe without isthmusectomy.
3. A 35-year-old female with a history of follicular thyroid carcinoma undergoes a total thyroid lobectomy of the right lobe with isthmusectomy.
4. A 60-year-old male with a history of medullary thyroid carcinoma undergoes a total thyroid lobectomy of the left lobe with isthmusectomy.
5. A 50-year-old female with a history of Hurthle cell carcinoma undergoes a total thyroid lobectomy of the right lobe without isthmusectomy.
6. A 40-year-old male with a history of anaplastic thyroid carcinoma undergoes a total thyroid lobectomy of the left lobe with isthmusectomy.
7. A 65-year-old female with a history of thyroid lymphoma undergoes a total thyroid lobectomy of the right lobe without isthmusectomy.
8. A 70-year-old male with a history of poorly differentiated thyroid carcinoma undergoes a total thyroid lobectomy of the left lobe with isthmusectomy.
9. A 30-year-old female with a history of insular thyroid carcinoma undergoes a total thyroid lobectomy of the right lobe without isthmusectomy.
10. A 75-year-old male with a history of columnar cell thyroid carcinoma undergoes a total thyroid lobectomy of the left lobe with isthmusectomy.