CPT code 60254 is a code used to describe extensive thyroid surgery, helping healthcare providers document and categorize the procedure accurately.
CPT code 60254 is used to designate an extensive thyroid surgery, meaning it refers to a thyroid operation that goes beyond a standard procedure. This may include a more complex removal or modification of thyroid tissue, potentially involving additional structures and requiring careful intraoperative management to address more advanced disease or anatomical variations.
For CPT code 60254, which pertains to extensive thyroid surgery, 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 factors such as increased complexity or time.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
3. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure: Used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier is used to indicate the involvement of both.
7. Modifier 66 - Surgical Team: When a team of surgeons is necessary to perform the procedure, this modifier is used to reflect the collaborative effort.
8. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure, this modifier is used to indicate the repetition.
9. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure is repeated by a different physician.
10. 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 when a patient needs to return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
12. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required to help with the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was necessary for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required due to the unavailability of a qualified resident.
15. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate the use of multiple modifiers.
Each of these modifiers serves a specific purpose and should be applied based on the unique circumstances surrounding the surgical procedure. Proper use of modifiers ensures accurate billing and reimbursement for the services provided.
The CPT code 60254, which pertains to extensive thyroid surgery, is reimbursed by Medicare, provided that the procedure meets the necessary medical necessity criteria and documentation requirements. Reimbursement rates for this CPT code can be found in the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B. It's important to note that the specific reimbursement amount can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). The MAC is responsible for processing claims and ensuring compliance with Medicare policies in their respective jurisdictions. Healthcare providers should consult the MPFS and their local MAC for the most accurate and up-to-date reimbursement information for CPT code 60254.
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