CPT code 60212 is a medical code used to describe a partial thyroid excision procedure performed by healthcare providers.
CPT code 60212 is a procedure that involves surgically removing a portion of the thyroid gland while leaving some of the gland intact.
html
For CPT code 60212, which involves partial thyroid excision, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to increased complexity or difficulty during the partial thyroid excision.
2. Modifier 51 - Multiple Procedures: If the partial thyroid excision is performed in conjunction with other procedures during the same surgical session, this modifier indicates that multiple procedures were performed.
3. Modifier 52 - Reduced Services: This modifier is applicable if the procedure was partially reduced or eliminated at the physician's discretion. For example, if the planned extent of the thyroid excision was reduced due to intraoperative findings.
4. Modifier 59 - Distinct Procedural Service: Use this modifier when the partial thyroid excision is performed as a distinct service from other procedures on the same day. It indicates that the procedure is not typically reported together but is appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to perform the partial thyroid excision again within a short period, this modifier indicates that the procedure was repeated.
6. Modifier 77 - Repeat Procedure by Another Physician: Similar to Modifier 76, but used when a different physician performs the repeat procedure.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial partial thyroid excision.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If an unrelated procedure is performed by the same physician during the postoperative period of the partial thyroid excision, this modifier is used.
9. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required during the partial thyroid excision, this modifier indicates their involvement.
10. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon is required for a minimal portion of the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident.
12. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier indicates the use of multiple modifiers.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement. It's important to review the specific payer policies and guidelines, as they may have unique requirements for modifier usage.
The CPT code 60212, which involves a partial thyroid excision, is reimbursed by Medicare, provided it meets the necessary criteria outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used to reimburse physicians and other healthcare providers for services rendered to Medicare beneficiaries.
However, reimbursement is not solely dependent on the MPFS. It is also subject to local coverage determinations (LCDs) made by Medicare Administrative Contractors (MACs). MACs are private organizations contracted by Medicare to process claims and make coverage decisions based on regional needs and policies. Therefore, while CPT code 60212 is generally reimbursable, healthcare providers should verify specific coverage details with their respective MAC to ensure compliance with any local policies or additional documentation requirements.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 60212, and by individual payer. Don't let hidden discrepancies impact your revenue. Schedule a demo today to see how RevFind can enhance your financial accuracy and boost your bottom line.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
