How To Use CPT Code 60500

CPT 60500 describes the surgical procedure known as parathyroidectomy or exploration of the parathyroid glands. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 60500?

CPT 60500 is used to describe the surgical removal of one or more parathyroid glands or the exploration of these glands to screen for pathology. The procedure involves making an incision in the lower part of the front of the neck, separating the skin and muscles, and gaining access to the parathyroid glands. The provider then identifies and removes any affected glands while taking care to avoid damage to surrounding structures.

2. Official Description

The official description of CPT code 60500 is: ‘Parathyroidectomy or exploration of parathyroid(s).’ This code is used to report the surgical removal of one or more parathyroid glands or the exploration of these glands to screen for pathology.

3. Procedure

1. The provider makes an incision in the lower part of the front of the neck, below the voice box.
2. The skin and muscles are separated into upper and lower flaps, and the strap muscles are separated from the midline.
3. The provider gains access to the parathyroid glands by pulling the thyroid back.
4. The pathological gland/glands are identified, and a small piece may be sent for immediate pathological investigation.
5. The affected gland/glands are removed while avoiding injury to surrounding structures.
6. Hemostasis is achieved to stop bleeding.
7. The overlying muscles and skin are closed in layers.

4. Qualifying circumstances

CPT 60500 is performed primarily in cases of primary hyperparathyroidism and parathyroid adenoma. It is used when there is a need to remove one or more parathyroid glands due to pathology. The procedure is typically performed by a qualified healthcare professional who has the necessary training and expertise in parathyroid surgery.

5. When to use CPT code 60500

CPT code 60500 should be used when a provider performs a parathyroidectomy or exploration of the parathyroid glands. It is appropriate to use this code when there is a need to surgically remove one or more parathyroid glands or when the provider needs to screen the glands for pathology. This code should not be used for other procedures or surgeries unrelated to the parathyroid glands.

6. Documentation requirements

To support a claim for CPT 60500, the healthcare professional must document the following information:

• Reason for the procedure, such as primary hyperparathyroidism or parathyroid adenoma
• Details of the surgical approach and technique used
• Identification of the pathological gland/glands
• Any immediate pathological investigation performed
• Steps taken to avoid injury to surrounding structures
• Hemostasis achieved to stop bleeding
• Details of the closure of muscles and skin

7. Billing guidelines

When billing for CPT 60500, ensure that the procedure performed is a parathyroidectomy or exploration of the parathyroid glands. It is important to use the appropriate CPT code based on the specific procedure performed. Modifier 59 may need to be appended to CPT 60500 if a unilateral thyroid lobectomy is also performed during the same surgery. It is important to review payer’s edits and guidelines to ensure accurate billing and reimbursement.

8. Historical information

CPT 60500 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a parathyroidectomy to remove a single parathyroid gland in a patient with primary hyperparathyroidism.
2. During a parathyroid exploration, the provider screens all four parathyroid glands and identifies and removes two glands with pathology.
3. A patient undergoes a parathyroidectomy to remove a parathyroid adenoma causing hypercalcemia.
4. A provider performs a parathyroid exploration to screen for pathology in a patient with recurrent kidney stones.
5. During a parathyroidectomy, the provider removes three parathyroid glands due to hyperfunctioning.
6. A patient with secondary hyperparathyroidism undergoes a parathyroidectomy to remove an enlarged parathyroid gland.
7. A provider performs a parathyroid exploration to investigate the cause of elevated parathyroid hormone levels in a patient with osteoporosis.
8. During a parathyroidectomy, the provider removes a parathyroid gland causing hypercalcemia in a patient with chronic kidney disease.
9. A patient with parathyroid adenoma undergoes a parathyroidectomy to remove the affected gland and alleviate symptoms.
10. A provider performs a parathyroid exploration to screen for pathology in a patient with a family history of parathyroid disorders.