2025 CPT code 60505
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Endocrine System Feed
Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach.
Modifiers may be applicable in specific circumstances (e.g., increased procedural services, assistant surgeon). Refer to current CPT guidelines for appropriate usage.
Medical necessity is established by documenting the patient's hyperparathyroidism diagnosis (primary or secondary), the presence of symptoms or complications related to elevated calcium levels, failed conservative management (if applicable), and the rationale for the chosen surgical approach (sternal split or transthoracic) based on the location of the affected parathyroid gland(s).Supporting documentation, including imaging and lab results, is essential.
The surgeon prepares the patient and administers anesthesia. Incisions are made depending on the approach used – sternal split (through the breastbone) or transthoracic (through the chest wall). The thyroid is exposed, and the parathyroid glands, particularly those in the mediastinum, are examined.The affected gland(s) are identified and removed. A sample is sent for pathology testing. A drain is placed, and the incision is closed.
In simple words: This procedure involves removing one or more of the small parathyroid glands near the thyroid in your neck or chest, usually because they're overactive. The surgeon makes an incision in the chest area, either through the breastbone or through the chest wall to access glands located in the center of the chest.This is a more complex procedure than a standard parathyroidectomy.
This code describes a surgical procedure involving the exploration or removal of one or more parathyroid glands, often to treat hyperparathyroidism.It involves a more complex approach with mediastinal exploration, requiring either a sternal split or a transthoracic incision to access the affected glands, often located within the mediastinum. The procedure involves identifying the parathyroid glands, isolating and removing the diseased tissue (such as an adenoma), and sending a sample to pathology. A drain is typically placed, and the wound is closed.
Example 1: A patient with hyperparathyroidism has an adenoma located in the mediastinum, requiring a transthoracic approach for removal., A patient has persistent hyperparathyroidism after an initial neck exploration, and further exploration of the mediastinum is required via a sternal split incision., Preoperative imaging suggests a possible mediastinal parathyroid adenoma causing hypercalcemia, requiring mediastinal exploration during parathyroidectomy.
Documentation should include operative reports detailing the surgical approach (sternal split or transthoracic), the location and size of the parathyroid gland(s) removed, any intraoperative findings (e.g., presence of adenoma), and confirmation of mediastinal exploration. Preoperative imaging reports, laboratory results showing hypercalcemia, and any relevant consultations should also be included.
** This code represents a more complex approach to parathyroidectomy than codes for standard neck explorations.The choice between sternal split and transthoracic approach depends on the specific location of the affected gland(s) and surgeon preference. As of December 1st, 2024, this information is current but may be subject to change.
- Revenue Code: P1G - Major Procedure - Other
- Specialties:Endocrine Surgery, General Surgery, Otolaryngology (in some cases)
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center