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The excision of a thyroglossal duct cyst or sinus, specifically coded as CPT® 60281, refers to a surgical procedure aimed at removing a recurrent cyst or sinus that originates from the thyroglossal duct. This duct is a remnant of embryonic development that typically involutes as the thyroid gland forms. However, when this involution does not occur, it can lead to the formation of cysts, which are fluid-filled sacs that appear as small lumps in the midline of the neck. In some cases, the duct may persist and create a sinus that opens onto the skin surface. The Sistrunk procedure is a well-established surgical technique used to excise these cysts and sinuses, significantly reducing the likelihood of recurrence. The procedure involves making a midline incision in the neck, carefully dissecting the tissue to reach the hyoid bone, and ensuring that the hypoglossal nerve is protected during the operation. The central portion of the hyoid bone is removed along with a cuff of tongue tissue that follows the cyst or sinus tract. This meticulous approach helps to prevent the formation of new cysts. After the excision, the wound is typically closed with absorbable sutures, and the skin is secured using Derma-Bond or Steri Strips, eliminating the need for suture removal. A light pressure dressing is then applied around the neck to support the healing process.
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The excision of a thyroglossal duct cyst or sinus is indicated for patients presenting with the following conditions:
The procedure for excising a thyroglossal duct cyst or sinus involves several critical steps to ensure successful removal and minimize the risk of recurrence:
Post-procedure care for patients who have undergone the excision of a thyroglossal duct cyst or sinus typically includes monitoring for any signs of infection or complications at the surgical site. Patients are advised to keep the area clean and dry, and to follow any specific instructions provided by their healthcare provider regarding activity restrictions and wound care. The use of absorbable sutures and skin adhesives eliminates the need for suture removal, simplifying the recovery process. Patients may experience some swelling and discomfort, which can be managed with prescribed pain relief medications. Follow-up appointments are essential to ensure proper healing and to assess for any signs of recurrence.
| Short Descr | REMOVE THYROID DUCT LESION | Medium Descr | EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT | Long Descr | Excision of thyroglossal duct cyst or sinus; recurrent | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 12 - Other therapeutic endocrine procedures |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | LT | Left side (used to identify procedures performed on the left side of the body) |
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