CPT code 60220 is a medical code used to describe the partial removal of the thyroid gland during a surgical procedure.
CPT code 60220 is used for the partial removal of the thyroid, indicating that only a portion of the thyroid gland is surgically excised rather than the entire organ.
For the CPT code 60220, which involves the partial removal of the thyroid, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their reasons for use:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required. This might be applicable if there are unusual complications or additional work involved in the partial removal of the thyroid.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the thyroid, this modifier indicates that the procedure was bilateral.
3. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session. This modifier helps in identifying that more than one procedure was carried out.
4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion. This might be applicable if only a portion of the planned thyroid removal is completed.
5. Modifier 53 - Discontinued Procedure: If the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier is appropriate.
6. Modifier 59 - Distinct Procedural Service: This is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
7. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, each performing distinct parts, this modifier is used to indicate the collaborative effort.
8. Modifier 66 - Surgical Team: Applied when a complex procedure requires the expertise of a surgical team, indicating that multiple professionals were involved in the surgery.
9. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier is used to indicate the repetition.
10. Modifier 77 - Repeat Procedure by Another Physician: Used when the procedure is repeated by a different physician.
11. 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.
12. 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, this modifier is applicable.
13. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was necessary for the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required and a qualified resident surgeon is not available.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 60220 is reimbursed by Medicare, but the reimbursement is subject to several factors. The Medicare Physician Fee Schedule (MPFS) determines the payment rates for services covered under Medicare Part B, including surgical procedures like those represented by CPT code 60220. The MPFS assigns a relative value unit (RVU) to each procedure, which is then adjusted by geographic location and multiplied by a conversion factor to determine the payment amount.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that may affect the reimbursement of specific CPT codes. Therefore, while CPT code 60220 is generally reimbursed by Medicare, healthcare providers should verify any specific coverage policies or requirements set by their regional MAC to ensure compliance and proper reimbursement.
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