OST-247 - Procedure Coding - Chapters 16 – 18 Graded A+
**Anatomy and Physiology**
Where are the adrenal glands located? A. Beneath the kidneys (False).
What is the endocrine system? A. A group of internal hormone-secreting glands and structures.
What is diabetes mellitus? A. A condition where the pancreas does not function properly or at all.
**Endocrine Surgery**
What is the CPT code for a complete thyroidectomy? A. Code: 60240.
What is the CPT code for a laparoscopic adrenalectomy? A. Code: 60650.
**Hormones and Glands**
What hormone regulates the levels of salt and water in the body? A. Aldosterone.
**Coding**
How would you code a complete thyroidectomy with radical dissection of the neck to treat a
malignancy? A. Code: 60254.
How would you code a partial thymectomy with radical mediastinal dissection, sternal split approach? A.
Code: 60522.
Preoperative diagnosis: Right thyroid nodule
, Postoperative diagnosis: Same
Procedure: Right thyroid lobectomy
Procedure performed: This 42-year-old female was placed supine on the operating table. General
anesthesia was induced, after which the neck was prepped and draped with Betadine. A transverse
incision was made in the skin fold on the right side of the neck, and was carried down through the skin
and subcutaneous tissues. The platysma and strap muscles were divided, and subplatysmal flaps were
then raised. The 4.5-cm thyroid nodule was encountered posteriorly on the nerve. It was then necessary
to ligate the inferior thyroid artery and vein, the middle thyroid vein, and the superior thyroid artery and
vein. The gland was then rotated medially for better access to the nodule. A Harmonic scalpel was used
to remove the nodule encompassing the right lobe, which was sent for pathology. The pathology came
back as a be ✔️60220
Reference the main term Lobectomy, then the term thyroid gland, total.
Preoperative diagnosis: Thyroglossal duct cyst
Postoperative diagnosis: Same
Anesthesia: General
Procedural Notes:
This 34-year-old male patient was placed in the supine position. He was then placed under general
anesthesia, and his neck was prepped and draped in the usual fashion and then flexed for the
procedure. The skin around the cyst was circumferentially incised, and the cyst and duct were dissected
free to the level of the hyoid bone. The midpoint of the hyoid bone was then excised. A 3-0 plain catgut
triple-strand suture was then used to ligate the thyroglossal duct. Iris scissors were used to remove the
cyst, and hemostasis was obtained. The wound site was closed in layers. No significant blood loss
occurred. The patient was in stable condition and sent to the recovery area. ✔️60280
Reference the main term Excision, then the subterm Cyst, then Thyroglossal Duct.
Craniectomy for drainage of intracranial abscess, infratentorial ✔️61321
Craniotomy for repair of encephalocele at skull base ✔️62121
Intradural cervical laminectomy for excision of intraspinal lesion ✔️63270
Repair of cerebrospinal fluid leak not requiring a laminectomy ✔️63707
**Anatomy and Physiology**
Where are the adrenal glands located? A. Beneath the kidneys (False).
What is the endocrine system? A. A group of internal hormone-secreting glands and structures.
What is diabetes mellitus? A. A condition where the pancreas does not function properly or at all.
**Endocrine Surgery**
What is the CPT code for a complete thyroidectomy? A. Code: 60240.
What is the CPT code for a laparoscopic adrenalectomy? A. Code: 60650.
**Hormones and Glands**
What hormone regulates the levels of salt and water in the body? A. Aldosterone.
**Coding**
How would you code a complete thyroidectomy with radical dissection of the neck to treat a
malignancy? A. Code: 60254.
How would you code a partial thymectomy with radical mediastinal dissection, sternal split approach? A.
Code: 60522.
Preoperative diagnosis: Right thyroid nodule
, Postoperative diagnosis: Same
Procedure: Right thyroid lobectomy
Procedure performed: This 42-year-old female was placed supine on the operating table. General
anesthesia was induced, after which the neck was prepped and draped with Betadine. A transverse
incision was made in the skin fold on the right side of the neck, and was carried down through the skin
and subcutaneous tissues. The platysma and strap muscles were divided, and subplatysmal flaps were
then raised. The 4.5-cm thyroid nodule was encountered posteriorly on the nerve. It was then necessary
to ligate the inferior thyroid artery and vein, the middle thyroid vein, and the superior thyroid artery and
vein. The gland was then rotated medially for better access to the nodule. A Harmonic scalpel was used
to remove the nodule encompassing the right lobe, which was sent for pathology. The pathology came
back as a be ✔️60220
Reference the main term Lobectomy, then the term thyroid gland, total.
Preoperative diagnosis: Thyroglossal duct cyst
Postoperative diagnosis: Same
Anesthesia: General
Procedural Notes:
This 34-year-old male patient was placed in the supine position. He was then placed under general
anesthesia, and his neck was prepped and draped in the usual fashion and then flexed for the
procedure. The skin around the cyst was circumferentially incised, and the cyst and duct were dissected
free to the level of the hyoid bone. The midpoint of the hyoid bone was then excised. A 3-0 plain catgut
triple-strand suture was then used to ligate the thyroglossal duct. Iris scissors were used to remove the
cyst, and hemostasis was obtained. The wound site was closed in layers. No significant blood loss
occurred. The patient was in stable condition and sent to the recovery area. ✔️60280
Reference the main term Excision, then the subterm Cyst, then Thyroglossal Duct.
Craniectomy for drainage of intracranial abscess, infratentorial ✔️61321
Craniotomy for repair of encephalocele at skull base ✔️62121
Intradural cervical laminectomy for excision of intraspinal lesion ✔️63270
Repair of cerebrospinal fluid leak not requiring a laminectomy ✔️63707
