CPT Code 60281 | Description & Clinical Information

CPT 60281 describes the Sistrunk procedure, which involves the complete surgical removal of the thyroglossal duct cyst or sinus, including its full extent up to the back of the tongue and a portion of the hyoid bone, and is typically performed to prevent the recurrence of cysts that may appear when a previous surgery did not remove sufficient tissue or when the patient’s infection was not under adequate control prior to surgery.

Official Description

The CPT book defines CPT code 60281 as: “Excision of thyroglossal duct cyst or sinus; recurrent”.

Billing Guidelines

CPT 76536 should be used for thyroid ultrasonography.

Clinical Information

The procedure described by CPT code 60281 is one that involves the removal of thyroglossal duct cysts, which are fluid-filled sacs that form from persistent embryonic tissue left over after the formation of the thyroid gland. These cysts are typically located near the midline of the neck and can cause discomfort, infections and sometimes even malignant transformation.

Before the provider can perform the procedure, they must ensure that the cyst is not infected by treating any bacterial infection present with antibiotics. Once the patient is appropriately prepped and anesthetized, the provider makes a small transverse incision in front of the neck over the cyst. The incision is typically 2-3 cm in length and is oriented parallel to the direction of the skin creases to minimize visible scarring.

After making the incision, the provider separates the skin into upper and lower flaps, allowing them to access the underlying muscles. Next, they dissect the platysma, the superficial muscle in the neck region, and separate the strap muscles from the midline. By doing this, they can expose the cyst and isolate it from the surrounding tissues.

Once the cyst is identified, the provider removes it completely along with the tract that it follows up to the base of the tongue if necessary. They may also need to remove a section of the hyoid bone, a bone in the neck that sits above the thyroid gland, if it is found to be involved with the cyst. The tissue removed is then sent for pathological investigation to confirm the diagnosis and exclude malignancy.

In cases where the cyst had not been completely removed in a previous surgery and has now come back or recurred, the provider may have to remove a larger amount of tissue to ensure complete excision. After achieving hemostasis, or stoppage of bleeding, the provider may place a drain, which is a small piece of tubing left in place to drain any residual fluid or blood, and then close the overlying muscles and skin in layers.

The recovery time for this procedure is typically brief, and many patients are able to return to normal activities within days of surgery. However, some patients may experience swelling, pain or numbness in the neck region for a few weeks, which usually resolves on its own.

Overall, the thyroglossal duct cyst excision procedure described by CPT code 60281 is a safe and effective method for removing cysts in the neck, providing relief from discomfort and preventing further complications. It is important to seek medical attention from a qualified provider if you experience any signs or symptoms of a cyst in the neck to receive appropriate management and avoid potential complications.

Return to all the CPT codes for excision procedures on the thyroid gland.