In simple words: The doctor removes the entire thyroid gland, including any part that extends below the breastbone. This surgery is done for complex problems like a very large goiter or a thyroid condition affecting the upper chest area. The doctor makes an incision either through the breastbone or through the chest to access and remove the thyroid.

This procedure involves the surgical removal of the thyroid gland, encompassing any extension of the gland beneath the breastbone.The approach utilized is either a sternal split or a transthoracic incision. This is indicated for complex benign conditions (e.g., very large goiter, cyst) or malignant conditions extending into the upper chest. The surgeon will incise the affected area, separate the platysma and strap muscles, create flaps to expose the thyroid gland, ligate thyroid vessels to improve mobility, dissect the lesion, free the gland from the trachea, and then remove the thyroid.

Example 1: A 50-year-old female presents with a large goiter extending significantly below the breastbone, causing respiratory compromise.A 60270 procedure is performed via a sternal split approach., A 62-year-old male is diagnosed with a substernal thyroid malignancy that has invaded the upper mediastinum.A transthoracic approach (60270) is selected for complete tumor resection., A 45-year-old female with a recurrent substernal goiter following a previous cervical thyroidectomy requires a 60270 procedure to remove the remaining thyroid tissue.

* Preoperative imaging (e.g., ultrasound, CT scan) demonstrating the extent of the goiter or tumor.* Operative report detailing the surgical approach, findings, and steps performed.* Pathology report confirming the diagnosis (benign or malignant).* Anesthesia record.* Postoperative recovery notes and any complications encountered.

** Consider the potential for complications such as hemorrhage, pneumothorax, or recurrent laryngeal nerve injury.Proper documentation is critical for accurate coding and reimbursement.