sure CPT codes are included and the payment is going to cover every-
thing — including the rare case of an overnight stay," says Ms. Van
Alstine. "Remember, this is a new procedure so you may have to go
back through your payer contracts and make sure everything is cov-
ered."
4. Total thyroidectomy.
Some procedures aren't
reimbursed by CMS, but
still get great reimburse-
ments from private payers
in most cases. One such
procedure is an outpatient
total thyroidectomy, a
minimally invasive surgery
to remove a patient's
entire thyroid. Such a pro-
cedure has become a high-
volume staple at Ohio Surgery Center in Columbus, where 137 of
these procedures were conducted last year alone.
Like any new surgical endeavor, you'll want to start slowly with
this procedure because instrumentation could be pricey, and there
may be some growing pains in terms of your scheduling. "You don't
want to go guns blazing and buy 5 sets of instruments if you're just
starting out and haven't done any cases," says Suzi Walton, the facil-
ity administrator at Ohio Surgery Center. "When we started, we
couldn't do more than 2 thyroid cases per day. As we grew the pro-
gram, we reinvested accordingly."
Speaking of instrumentation, you'll need a soft tissue tray and a
thyroid tray, as well as a harmonic scalpel — a device that can
6 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 9
• TOTAL THYROIDECTOMY Traditionally, the thyroid has been removed
through a neck incision that leaves a permanent scar. More recently, mini-
mally invasive and "scarless" approaches such as transoral thyroidectomy
have become popular in some parts of the world.
