How To Use CPT Code 60270

CPT 60270 describes the surgical procedure known as thyroidectomy, specifically when it involves a sternal split or transthoracic approach. This article will provide an overview of CPT 60270, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when CPT 60270 may be used.

1. What is CPT Code 60270?

CPT 60270 is a code used to describe the surgical removal of the thyroid gland, including cases where the gland extends below the breastbone. This procedure is typically performed for more complex benign conditions, such as large goiters, cysts, or benign or malignant conditions that extend into the upper chest.

2. Official Description

The official description of CPT code 60270 is: ‘Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach.’

3. Procedure

1. During the procedure, the healthcare provider makes an incision in the region of the enlarged cyst, goiter, or cancer.
2. They then divide the platysmas, which are muscle fibers extending from the collarbone to the jaw.
3. The provider separates the strap muscles, also known as the infrahyoid muscles, which are four pairs of muscles in the front of the neck.
4. Short flaps are created from this tissue to expose the thyroid gland.
5. Before dissecting the substernal thyroid, the provider ties off the vessels of the thyroid gland to free the gland and increase its mobility.
6. The cyst or lesion is then dissected, and the thyroid gland is released from the trachea and removed.

4. Qualifying circumstances

CPT 60270 is used for cases where the thyroidectomy involves a sternal split or transthoracic approach. This procedure is typically performed for more complex benign conditions, such as large goiters, cysts, or benign or malignant conditions that extend into the upper chest.

5. When to use CPT code 60270

CPT code 60270 should be used when a thyroidectomy is performed using a sternal split or transthoracic approach. It is important to accurately document the specific approach used during the procedure to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 60270, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for thyroidectomy
• Specific approach used during the procedure (sternal split or transthoracic)
• Date of the procedure
• Details of the procedure, including any complications or additional steps taken
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 60270, it is important to accurately document the specific approach used during the procedure (sternal split or transthoracic). Additionally, it is crucial to follow any specific billing guidelines provided by insurance carriers or payers. It is also important to note that CPT 60270 should not be reported with other codes unless specifically indicated by the payer.

8. Historical information

CPT 60270 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2002, with the addition of the term ‘substernal thyroid gland’ to the description. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a thyroidectomy using a sternal split approach to remove a large goiter that extends below the breastbone.
2. A healthcare provider performs a thyroidectomy using a transthoracic approach to remove a cyst that has grown into the upper chest.
3. A patient with a benign thyroid condition undergoes a thyroidectomy using a sternal split approach.
4. A thyroidectomy is performed using a transthoracic approach to remove a malignant tumor that has extended into the upper chest.
5. A patient with a large goiter undergoes a thyroidectomy using a sternal split approach to alleviate symptoms and improve breathing.
6. A healthcare provider performs a thyroidectomy using a transthoracic approach to remove a cyst that has caused significant discomfort and compression of nearby structures.
7. A patient with a benign thyroid condition undergoes a thyroidectomy using a sternal split approach to prevent further growth and potential complications.
8. A thyroidectomy is performed using a transthoracic approach to remove a malignant tumor that has invaded the upper chest.
9. A patient with a large goiter undergoes a thyroidectomy using a sternal split approach to improve their quality of life and alleviate symptoms.
10. A healthcare provider performs a thyroidectomy using a transthoracic approach to remove a cyst that has caused difficulty swallowing and breathing.