Laureen: You guys, I think you’re going to like this, for those who have not taken
the board exam, the next two slides are taken from CCO Practice Exam.
Thyroidectomy Practice Exam Question – As I’m reading it, think about what you think
the answers before I go into what the answer is.
Q: A patient has the lower ½ portion of the right lobe of the thyroid as well as the lower
1/3 of the left lobe and the isthmus (the little connecting thing in the middle) excised.
What CPT code(s) are reported? A: I might have had
a poll. So, you see the answers: A) 60240-52 – and I have it on the slide, that’s a
total or complete thyroidectomy. B) 60212 x2 – so two units of it, that’s a partial
thyroidectomy, unilateral with contralateral subtotal lobectomy, including isthmusectomy.
C) 60210-LT, 60210-RT – 60210 is a partial thyroid lobectomy, unilateral with or without
isthmusectomy. D) 60212, which is the one that we read before, but it’s only one unit
of it. What do you think it is? A, B, C, or D? And
I’m going to launch a poll. You can pop in your answer. We’re going to try and do
more of these. Whoa! The votes are flying in! You guys like this. What do you think
it is? And don’t worry, we’re not going to come after if you get it wrong.
This is a screen print that I got from SuperCoder, I like when you put in a range of codes and
then you can kind of show them stacked on top of each other. If only we could do that
in the real board exam, take in our encoders, right? 54% voted. Come on, I know you’re
out there, take a guess. In the board exam and the proctor said, “You have two seconds
left.” I’m going to close it down in 5, 4, 3, 2, 1… So, 52% said it was answer “C”
and a few fell for “A,” 17% said “B” and 26% said “D.”
Let’s break it down… here’s the rationale as it’s given if this was a practice exam
that you purchased. It would tell you in the CPT Index, look for thyroidectomy, then go
to partial. Only the lower half of the right lobe and the lower third of the left lobe
are excised and this points to the range 60210 to 60225. When you turn there, CPT code 60212
reports a partial thyroidectomy for both sides and includes the removal of the isthmus.
What I want to do is show you a picture right from CPT, this is what you would be looking
at on the board exam is your manual. Nice little picture here. The way I like to teach
this, if you picture the thyroid as a butterfly and the isthmus is in the middle of the butterfly
and you have a right and left side. When you look at the code options in the range, 60210
is a partial thyroid lobectomy, unilateral (so just one side) with or without isthmusectomy.
In my mind, I convert that to about one-quarter of the butterfly. So it’s not a complete
half, but it’s just one side, so one-quarter. The indented code, 60212, with contralateral
– that means the opposite side, sounding close, right? – lobectomy including isthmusectomy.
This is basically half the butterfly; so a little bit of one side, a little bit of the
other side. 60220 is a total thyroid lobectomy – that’s
on one side, again with or without isthmusectomy. To me, because it’s one whole half, that’s
half the butterfly, it’s one of the lobes. 60225, indented underneath that, says with
contralateral (so it’s the opposite side), subtotal (which just means part) lobectomy
– so that’s three-quarters of the butterfly. Finally, we’ve got the whole butterfly,
60240 – that’s a thyroidectomy, total or complete.
Now, with that little illustration, what do you think the answer is? Contralateral means
the opposite side, so we have a little bit on one side and a little bit on the other.
That’s going to be your 60212. So, hopefully that little picture helped. I’m a very visual
person; I got to break it down that way. The reason that’s only one unit, 60212 says
it includes this parent code here, the non-highlighted part, partial thyroid lobectomy, unilateral
and then with contralateral on the other side. You only need one unit, it tells that story
of the little bit on one side and a little bit on the other. So, those of you that picked
“D” good job.