Randomization (and validation of the inclusion). An adverse event (AE) is any untoward medical occurrence in a patient that does not necessarily have a causal relationship with the study intervention/procedure (thyroidectomy, neck dissection, radioiodine, and rhTSH administration). We are considering reporting CPT codes 60252, 60512, and 31575. What codes should be assigned for the total thyroidectomy with the central neck dissection and the parathyroid reimplantation? Boundaries: Anterior belly of the digastric muscle and the hyoid bone. Skin incisions were made along previous local infiltration areas on the lower neck, followed by dissection of the central neck. The thyroid gland is mobilized, and the superior and inferior thyroid vessels are ligated. endobj Selective neck dissection is an operative procedure that removes cervical lymph nodes at risk of metastatic disease, and it is defined by the preservation of one or more lymph node groups which are routinely removed during radical neck dissections. A patient will be in remission if the requirements are met at 1 year following randomization. Patients will be evaluated at 8 +/2 months post-iodine (814 months postoperatively or 1 year) then yearly with neck ultrasound, unstimulated ultrasensitive thyroglobulin (usTg/LT4), and anti-Tg antibodies. 60212- with contralateral subtotal lobectomy, including isthmusectomy. What are the different types of neck dissections? The Voice Handicap Index is composed of 10 self-administered questions relating to the functional, physical, and emotional aspects of voice. Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France, Dana Hartl,Yann Godbert,Xavier Carrat,Stphane Bardet,Audrey Lasne-Cardon,Pierre Vera,Elena Ilies,Slimane Zerdoud,Jrme Sarini,Mohamad Zalzali,Luigi La Manna,Olivier Schneegans,Antony Kelly,Philppe Kauffmann,Patrice Rodien,Laurent Brunaud,Solange Grunenwald,Elie Housseau,Salim Laghouati,Nathalie Bouvet,Elodie Lecerf,Julien Hadoux,Livia Lamartina,Martin Schlumberger&Isabelle Borget, You can also search for this author in Once randomized, patients must be treated as defined in the assigned group and cannot change. In no other instances does this study provide for discontinuing or modifying allocated interventions. Terms and Conditions, Federal government websites often end in .gov or .mil. https://doi.org/10.1245/s10434-010-1137-6. Brierley J, Gospodarowicz M, Wittekind C. TNM Classification of Malignant Tumors. Outcomes for patients with papillary thyroid cancer who do not undergo prophylactic central neck dissection. PubMed Central Any change to a payment requires a 30-day notice. If we look at our first question of whether the entire thyroid was removed or only a portion, we can see that only a portion of the thyroid was removed (see the words highlighted in green that indicate the left lobe was being freed up but the isthmus was divided from the right lobe of the thyroid). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The number of lymph nodes resected, the number of metastatic nodes, their size, and the presence or absence of extranodal spread will be recorded. But when removing a malignant lymphatic chain, she manages to preserve the spinal accessory nerve, jugular vein and sternocleidomastoid muscles. Thyroidectomy is mainly classified into partial thyroidectomy and Total thyroidectomy. 3 0 obj in Laryngoscope 130(6):1603-1608, 2020). Modified radical neck dissections are more complex than radical neck dissections. Centers in France and outside of France may be added as investigators, subjected to approval of an amendment to the study by the national authorities (National Agency for Drug Safety, Agence Nationale de la Scurit du Mdicament et des Produits de Sant, ANSM) and the French nationa research ethics committee (Comit de Protection des Personnes, CPP). Each participating center will retain pathology specimens as per French laws, health authorities biobanking decrees and routine standard of care, which may be accessed for future studies. Tumors with extrathyroidal extension suspected or obvious on the preoperative work-up or intra-operatively (cT3T4), Metastatic neck lymph nodes or suspicious neck nodes on preoperative ultrasound (cN1); for suspicious nodes, FNAB cytology and thyroglobulin assay on the needle washout fluid will be performed, Metastatic neck lymph nodes found during the thyroidectomy and confirmed with intra-operative frozen section analysis, Medullary thyroid carcinoma on FNAB cytology and/or with basal serum calcitonin >50 pg/ml, Preoperative or intra-operative suspicion of non-papillary thyroid carcinoma or aggressive histopathological subtype or poorly differentiated carcinoma, Distant metastases (M1) apparent preoperatively (found due to symptoms or fortuitously; no specific preoperative work-up will be performed, however, in accordance with current clinical practice), Recurrent nerve paralysis visualized on systematic preoperative laryngoscopy and/or abnormal preoperative serum calcium, Participation in another therapeutic clinical trial within 1 year from study entry, Patient under guardianship or deprived of their liberty by a judicial or administrative decision or incapable of giving their consent. Thyroid. 60252. QALY will be calculated by multiplying the length of time between two questionnaires by utility score. A sensitivity analysis using the intent-to-treat (ITT) population, considering all patients in their initial group of randomization, will also be performed, to test the robustness of the results. A typical student microscope with a rotating platform that allows the user to select from three objective lenses. 2022 Aug 19;14(16):4016. doi: 10.3390/cancers14164016. https://doi.org/10.1186/s13063-023-07294-0, DOI: https://doi.org/10.1186/s13063-023-07294-0. What are the five stages of the project life cycle PPT. Revue de laryngologie - otologie - rhinologie. Accrural will be carried out for 6 years, for a total duration of 11 years for the study (5 years after randomization of the last patient). For all patients, Tg/LT4 and anti-Tg antibodies (anti-Tg Ab) measured 8 +/2 weeks postoperatively, before stimulation with recombinant human thyrotropin (rhTSH). 60260 Thyroidectomy, removal of all remaining thyroid tissue following the previous removal of aa portion of the thyroid.The parenthetical note following code 60260 instructs users to append modifier 50 for a completion thyroidectomy when tissue is resected from both sides of the neck. Further information can be requested (by fax, telephone or when visiting) by the monitor and/or the safety manager. Because the codes for glossectomy were created years ago, the CPT codebook does not provide for this modern and more common technique. Argumentaire de la recommandation: Prise en charge des cancers diffrencis de souche folliculaire du corps thyrode de ladulte. [34] is significant but with a non-inferiority margin of 15% and an alpha of 0.05. (Leboulleux 2022). You're going to get into these 60252 codes. DMH: Principal Investigator, study conception and oversight. Additional informed written consent is obtained at the same time for use of biological specimens for research, in accordance with the articles L1211-1 to 9 of the French Public Health Code. Lymph Node Dissection. Roh JL, Park JY, Rha KS, Park CI. SL: Promotor pharmacovigilance. ** Medical judgment should be exercised in deciding whether an AE is serious in other situations. The surgeons, endocrinologists, radiologists, and nuclear medicine physicians participating in this clinical trial are practitioners exercising medicine in either a university hospital or a comprehensive cancer center in France that belongs to the ENDOCAN-TuThyRef network, a network for treatment of thyroid cancer sponsored and financed by the French National Cancer Institute. Then, for all patients (whichever the group), radioactive iodine will be administered after 2 months but within 4 months postoperatively: 30 mCi (1.1 GBq) 131I after stimulation with human recombinant thyrotropin (rhTSH). Pre-registration (inclusion) of eligible patients after signed informed consent. Ann Surg. CPTxae 60240, Under Excision Procedures on the Thyroid Gland The Current Procedural Terminology (CPTxae) code 60240 as maintained by American Medical Association, is a medical procedural code under the range Excision Procedures on the Thyroid Gland. There are 3 main types of neck dissection surgery: Anatomical neck level VI or central compartment of the neck refers to the LNs that located between the carotid arteries from the innominate artery to the hyoid bone, includes the pretracheal, prelaryngeal and parartracheal LNs (3). In this area, the muscle, nerve, salivary gland, and main blood vessel have all been removed. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms 60271 cervical approachThe procedure involves surgical removal of the thyroid gland, including its extension into the thorax below the sternum. All parathyroid glands were left in situ and all attachments were released. Thyroid. She biopsies the tongue lesion, which turns out to be a squamous carcinoma. 60240. The Role of Carbon Nanoparticles in Lymph Node Dissection and Parathyroid Gland Preservation during Surgery for Thyroid Cancer: A Systematic Review and Meta-Analysis. The thyroid is approached (meaning the surgeon gains access to the thyroid) through an incision in the neck. 1The level system is used to describe the location of lymph nodes in the necks lymph nodes: submental and submandibular groups; upper jugular groups; upper jugular groups; middle jugular groups; lower jugular groups; posterior trian- gle groups; and anterior compartments. 60252 -Thyroidectomy, subtotal or total for malignancy, with limited neck dissection.Code represents a total thyroidectomy with limited lymph node dissection. This may mean that follow-up should continue once the patient has left the trial. A systematic review of the literature and an analysis of evidence-based recommendations were performed regarding central neck node dissection for patients with papillary thyroid carcinoma. No charge. From the jawbone to the collarbone, all of the tissue on the side of the neck has been removed. limited dissection. After that period, routine follow-up as standard of care will be performed. 2021 Nov 30;13(23):6028. doi: 10.3390/cancers13236028. A common model has objective focal lengths of 18 \mathrm {~mm}, 4.0 \mathrm {~mm} 18 mm,4.0 mm, and 1.6 \mathrm {~mm} 1.6 mm. The immune cells in the lymph nodes help the body fight infection. 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). Woisard V, Bodin S, Puech M. The Voice Handicap Index: impact of the translation in French on the validation. Copyright 2023, AAPC Prophylactic central neck dissection in clinically low-risk cT1bT2N0 papillary thyroid carcinoma is controversial, due to a large number of conflicting retrospective studies, some showing an advantage in terms of locoregional recurrence, others showing no advantage. All patients will have Tg/LT4 measured 8 +/2 weeks postoperatively, before stimulation with recombinant human thyrotropin (rhTSH). This protocol was submitted to the French National Research Ethics Committee (CPP IDF 2) which gave its approval on 13/02/2018 (annex 9). These are (1) radical neck dissection is considered to be the standard basic procedure for cervical lymphadenectomy, and all other procedures represent 1 or more alterations of this procedure; (2) when the alteration involves preservation of 1 or more nonlymphatic structures routinely removed in the radical neck. Therefore, no data transfer will be needed. 2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer. The Sponsor can temporarily or permanently discontinue an investigator for participation in the clinical trial at any time. PubMed CPT 38724 is for cervical lymphadenectomy (modified radical neck dissection), and because right selective neck and central compartment neck dissection falls under the radical part of the procedure rather than the complete removal lymphadenectomy, CPT 38724 is the appropriate code for this situation. It is not planned to publish other related patient documents (photographs or videos), so that this type of consent is not applicable to the study. Finally, the 2012 guidelines from the French Society of Otolaryngology Head and Neck Surgery recommend systematic PND [15]. Oxford: Wiley Blackwell; 2017. Multinodular goiter that is nontoxic. In store, they usually pin or, Youll be compensated as a freelancer, and youll need to register with the BBCs online invoicing system. Level VI neck dissection and central neck dissection are terms often used interchangeably to describe surgical excision of all lymph nodes from the hyoid bone to the sternal notch between the carotid arteries, but the addition of the superior mediastinal lymph nodes in compartment VII should be included in the central neck dissection. A secondary objective, however, is to also compare the thyroglobulin levels 8 weeks after surgery and before administration of RAI in each group, to evaluate outcomes without RAI. 1993;25(4):55978. Wang TS, Cheung K, Farrokhyar F, Roman SA, Sosa JA. Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma. For example, guidelines from the American Thyroid Association (ATA),[13] The European Society of Endocrine Surgeons,[24] the German Association of Endocrine Surgeons,[16] and the Francophone Association of Endocrine Surgery [19] do not recommend PND. J Clin Endocrinol Metab. The incision for complete central neck dissection during thyroidectomy is that of the standard thyroidectomy. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. No interim analysis has been planned for this study. 60254. with radical neck dissection. Reasons for withdrawal from the trial (study interventions and follow-up) may include: If a patient does not return for a scheduled visit, every effort will be made to contact them. Learn how to get the most out of your subscription. To read the full article, sign in and subscribe to the AHA Coding Clinic for HCPCS. Version franaise pour le Canada (French version for Canada). Non-compliance with the International Conference on Harmonisation (ICH) guideline for Good Clinical Practice. Instead, report the appropriate code that refers to glossectomy without radical neck dissection (such as 41120, 41130, 41140 or 41150), along with 38724 Cervical lymphadenectomy [modified radical neck dissection]. Brassard M, Borget I, Edet-Sanson A, Giraudet AL, Mundler O, Toubeau M, et al. Background and Objectives: Carcinoma showing thymus-like differentiation (CASTLE) is a low-grade thyroid carcinoma, with an indolent clinical course and usually a favorable prognosis. We then approached the left lobe of the thyroid and freed the lobe from a superior to inferior direction until all attachments were released. This trial will ultimately include a number of patients with intermediate risk factors (Haugen) found on finally pathology. . Mean sub-scale scores will be compared using a Student test for each time of evaluation (or a Kruskall-Wallis non-parametric test if they are not normally distributed). Lang BH, Ng SH, Lau LL, Cowling BJ, Wong KP. An AE can therefore be any unfavorable or unintended sign (including an abnormal laboratory finding), symptom, or disease temporarily associated with a trial procedure. 2022;171(1):1829. Saint-Cloud: LEuropenn ddition. To compare total thyroidectomy and radioactive iodine (131I) to total thyroidectomy with bilateral prophylactic central compartment neck dissection and 131I in terms of: Thyroglobulin levels after surgery alone (usTg/T4) measured while on T4 treatment, 8+/2 weeks postoperatively, before stimulation and administration of radioactive iodine. Central lymph node dissection is a neck level 6 dissection. Guide to Good Manufacturing Practices (revised and adopted in February 2010 by the European Commission). All payment plans and subscriptions are courtesy of AMCI and are not cancellable until paid in full. We hypothesize that thyroidectomy alone is not inferior to thyroidectomy with PND by more than 5% at 1 year. Patients, after total thyroidectomy, will need daily thyroid hormone treatment to replace the natural thyroid function. % This questionnaire has been employed in a previously published randomized controlled trial on thyroid cancer [40, 55]. The platysmas and skin are closed. It all depends on your size. Prophylactic central neck dissection in patients without detectable nodal disease remains a controversial topic due to a lack of definitive evidence of improved recurrence rates or survival and the possibility of higher complication rates compared to total thyroidectomy alone. Was the entire thyroid removed or only a portion? Surgeon utilizes a standard neck incision, typically measuring about 4-5 inches in length. Barczynski M, Konturek A, Stopa M, Nowak W. Prophylactic central neck dissection for papillary thyroid cancer. Differentiated thyroid carcinoma is the most common endocrine malignancy, with an increasing incidence in part related to an improvement in screening for small tumors by neck ultrasound. Article We NEVER sell or give your information to anyone. Percent of patients at 1, 3, and 5 years after randomization with structural incomplete response in the neck defined by a malignant lesion in the neck detected by ultrasound and confirmed by cytology (and/or Tg in the needle washout fluid >10ng/ml). If you can, remove the Object. The presence of metastasis is associated with increased recurrence rates and may decrease survival. During a thyroidectomy, the surgeon removes part or all of the thyroid gland. American Thyroid Association Surgery Working G, American Association of Endocrine S, American Academy of O-H, Neck S, American H, Neck S, et al. CPTxae Code 60100 Excision Procedures on the Thyroid Gland Codify by AAPC. The following information should be captured for all SAEs: onset, duration, intensity, seriousness, relationship to study procedure, action taken, and treatment required. This is the most common type of neck dissection. Revised American Thyroid Association management guidelines for, Carty SE, Cooper DS, Doherty GM, et al. For several minutes, rinse the wound under clean water. Thyroidectomy procedures involve surgical removal of all or part of the thyroid gland. Major deviation is defined as any conditions, practices, or processes that might adversely affect the rights, safety, or well-being of the subjects and/or the quality and integrity of data. Amendments will be communicated directly by the promotor to the participating centers who will, if applicable, inform trial participants. BNY Mellon Building 500 GRANT STREET SUITE 2900 Pittsburgh, PA 15219, Partial thyroid lobectomy, unilateral; with or without isthmusectomy, with contralateral subtotal lobectomy, including isthmusectomy, Total thyroid lobectomy, unilateral; with or without isthmusectomy, Thyroidectomy, total or subtotal for malignancy; with limited neck dissection, Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid, Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach. Conzo G, Mauriello C, Docimo G, Gambardella C, Thomas G, Cavallo F, Tartaglia E, Napolitano S, Varriale R, Rossetti G, Fei L, Santini L. Int J Surg. California Privacy Statement, MeSH The investigator also transmits the final report at the time of resolution or stabilization of the SAE. ICD-9 and CPT Codes for Included Cases eTable 2. . Level VI neck dissection and central neck dissection are terms often used interchangeably to describe surgical excision of all lymph nodes from the hyoid bone to the sternal notch between the carotid arteries, but the addition of the superior mediastinal lymph nodes in compartment VII should be included in the central. Quality control of data at the investigating site by the Clinical Research Assistant (CRA) in accordance with the monitoring plan. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma. If you continue to use this site we will assume that you are happy with it. Careers. It is employed for the calculation of the utility score for the calculation of QALY (quality-adjusted life years) in cost-utility analysis. Today, surgeons prefer to perform modified radical neck dissections whenever possible, so as not to jeopardize function of the spinal accessory nerve, jugular vein and sternocleidomastoid muscles. 2015;33(26):288592. Example 1: After sterile prep and drape, a midline cervical incision was created and the strap muscles were divided. Consequently, in case it is stated that a central neck dissection is carried out with a total thyroidectomy, you would report 60252 (Thyroidectomy, total or subtotal for malignancy; with limited neck dissection). Each user will have personal identifiers (user ID / password), and data access will be strictly limited according to profiles. ), as well as the original documents (laboratory results, imaging studies, medical consultation reports, clinical examination reports, etc. Patients will be randomized 1:1 into two groups: the reference group total thyroidectomy with bilateral prophylactic central neck dissection, and the comparator group total thyroidectomy alone. https://doi.org/10.1186/s13063-023-07294-0, https://afce-chirurgie-endocrinienne.com/wp-content/uploads/2019/11/afce_concensus_cancerthyroide0907.pdf, https://www.santepubliquefrance.fr/maladies-et-traumatismes/cancers/cancer-du-sein/documents/rapport-synthese/estimations-nationales-de-l-incidence-et-de-la-mortalite-par-cancer-en-france-metropolitaine-entre-1990-et-2018-volume-1-tumeurs-solides-etud, https://doi.org/10.1245/s10434-010-1137-6, https://sante.gouv.fr/IMG/pdf/proms_eq5d5l_generique.pdf, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. By definition, you must not distinctly report the radical neck dissection (38720, Cervical lymphadenectomy [complete]). Clean and protect the wound. 2013;20(6):191826. As you can see, breaking down a complex surgical procedure like a thryoidectomy by researching unfamiliar terminology and answering key questions to understand what tissue was removed and how the procedure was accomplished simplifies the coding process and helps you to build confidence that you are selecting the correct CPT codes. Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL, et al. New Engl J Med. Our study differs from these published studies in the following ways: Our study includes only tumors 11 mm (microcarcinomas are not eligible), whereas all of the studies cited in Table 1, with the exception of the study by Sippel et al. 2012;255(4):77783. Probabilistic sensitivity analyses will be performed using bootstrap resampling to estimate the uncertainty around the incremental cost-utility ratio. LL, JH: study co-investigators and co-coordinators TuThyRef network. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/cancers/cancer-du-sein/documents/rapport-synthese/estimations-nationales-de-l-incidence-et-de-la-mortalite-par-cancer-en-france-metropolitaine-entre-1990-et-2018-volume-1-tumeurs-solides-etud. Since the thyroid has only two lobes (one on each side), if both lobes were removed (bilateral), I would use 60240. Recruiting centers belong to the ENDOCAN-TuThyRef network and are regionally in France high-volume referral centers regularly performing clinical trials on thyroid cancer. Ann Surg Oncol. Keep your critical coding and billing tools with you no matter where you work. Please check if you agree to the following: To not disclose AMCI proprietary content. - The Good Clinical Practices guidelines (International Conference on Harmonization ICH E6) and Statistical Principles for Clinical Trials (ICH E9), - The Clinical Safety Data Management guidance (ICH E2A), and. Thyroid. Centers not including patients may be subjected to closing. Estimations nationales de l'incidence et de la mortalit par cancer en France mtropolitaine entre 1990 et 2018. Since CPT code 60252, Thyroidectomy, total or subtotal for malignancy; with limited neck dissection, includes subtotal in the descriptor, would this be the appropriate code for the procedure performed? This study aims to provide level I evidence with a multicenter prospective open randomized non-inferiority trial comparing bilateral PND with total thyroidectomy to total thyroidectomy alone (and adjuvant radioactive iodine in both groups) for low-risk papillary thyroid cancer patients cT1bT2N0 in terms of the rate of complete remission at 1 year after randomization. What is central compartment neck dissection? A French version has been validated [45]. However, the role of systematic prophylactic neck dissection (PND) in the absence of suspected neck metastases on preoperative ultrasound (cN0) remains controversial. Inclusion and non-inclusion criteria and patient consent, Anxiety (State-Trait Anxiety Inventory) (Annex 4) [49], Subjective dysphonia and dysphagia (measured via the Voice Handicap Index (ANNEX 5) [45] and SWAL-QOL) (Annex 6)[46], Group 1 (reference group): total thyroidectomy with bilateral prophylactic central compartment neck dissection. Patient has papillary thyroid carcinoma and presents for a total thyroidectomy with central neck dissection, reimplantation of parathyroid into the strap muscle, direct and flexible laryngoscopies were performed at the beginning and end of the surgery, and bilateral cranial nerve EMG monitoring tubes. In a similar prospective multicentre trial, 90.2% of the low-risk patients, including patients T1T3 N0N1 with or without central compartment neck dissection, were in complete remission 1 year after surgery and administration of 131I after rhTSH [42]. If known, the diagnosis of the underlying illness or disorder should be recorded, rather than its individual symptoms. 60225 -with contralateral subtotal lobectomy, including isthmusectomyOne entire thyroid lobe is removed including the isthmus and most part, but not all, of the oppositethyroid lobe. Our experience. This study is entirely financed by a grant from the French National Cancer Institute (InCA, PHRC-K15-182) (annexes 8 and 8 bis). Ann Surg Oncol. If the study confirms the non-inferiority of TT versus TT + PND in terms of oncologic events, a horizon time of 1 year following the initial surgery will be considered. The clinical and imagistic features are not specific for CASTLE but similar to other malignant lesions of the thyroid. Thyroidectomy, total or subtotal for malignancy; with limited neck dissection. Appending modifier 59 will not separate this bundle even if the thyroid is being removed for a separate reason, (such as for a neoplasm of the thyroid). Zetoune T, Keutgen X, Buitrago D, Aldailami H, Shao H, Mazumdar M, et al. When a physician performs a total parathyroidectomy, he may reimplant one gland in the forearm muscle to provide residual parathyroid function and easy access to the remaining gland after surgery. The final pathology results showed papillary thyroid cancer. One data manager is assigned to the present study with backup from the team. Non-inferiority will be demonstrated if the rate of patients in complete remission at 1 year after randomization does not differ by more than L=5%. Sippel RS, Robbins SE, Poehls JL, Pitt SC, Chen H, Leverson G, et al. Under Excision Procedures on the Thyroid Gland CPT 60240 is a medical procedural code in the range Excision Procedures on the Thyroid Gland, as maintained by the American Medical Association. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); A leading online medical coding education and training institute responsible for over 4000 medical coding certifications since 2015. Using this analogy, in this case, CPT code 60220 includes removal of either the left or the right wing (but not both) and may include removal of the body of the butterfly attached to the wing being removed (though removing the body is not a requirement in order to make this the right CPT code based on the words with or without removal of the isthmus, or the body in the description). Quality of life (SF-36, EQ-5D, STAI) questionnaires will be completed by the patient within 1 month before the surgery. CAS The authors declare that they have no competing interests. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Procedure: Hemi-thyroidectomy + CLND. Zhao W, You L, Hou X, Chen S, Ren X, Chen G, et al. While code 38700 is properly used to code the very limited SHND involving level I only, all other SNDs are reported with CPT code 38724, Cervical lymphadenectomy .

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