This edition of “Spotlight on CPT” will address coding for thyroglossal duct cyst excisions. This month’s installment of “In the kNOW” addressed the coding for this condition and procedure in the ICD-10-CM and ICD-10-PCS classifications. Now, I’ll share how to code for this in CPT.
As a review, a thyroglossal duct cyst is a remnant of tissue from embryonic development. At the point where the tongue separates into anterior and posterior segments, is a midline depression or pit identified as the foramen cecum. From this area, the thyroid diverticulum or tubular duct descends, with the gland moving into its final position in the neck. In circumstances where the duct fails to close, a cyst may occur.
When coding for the excision of a thyroglossal duct cyst in CPT, there are two choices: 60280 or 60281. CPT code 60280 describes the excision of the thyroglossal duct cyst or sinus. Unfortunately, the recurrence rate for thyroglossal duct cysts is about 56% after an initial removal. If it recurs and a second surgery is performed to remove the cyst, code 60281 for excision of the thyroglossal duct cyst or sinus, recurrent would be assigned.
Sistrunk procedures may be used for the removal of a thyroglossal duct cyst. This procedure removes not only the cyst, but also a portion of the hyoid bone and surrounding tissue. There is a dramatic impact on the recurrence rate when Sistrunk procedures are performed. The recurrence drops from approximately 56% to just over 5%. Regardless, the same codes are used for the procedure based on whether it is an initial or recurrent excision.
Now, light has been shed on coding thyroglossal duct cyst excisions.
About the Author
Dianna Foley, RHIA, CHPS, CCS, CDIP is
OHIMA's Coding Education Coordinator. Dianna has been an HIM
professional for 20 years. She progressed through the ranks of coder,
department supervisor, and department director, to her current role as a
coding consultant. She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.
