Thyroid Surgeries (Thyroidectomy & Lobectomy) - Medicare Advantage

This Medicare Advantage policy covers surgical thyroid procedures—lobectomy and thyroidectomy (specific CPT codes listed)—for diagnosis and treatment of thyroid disease. Coverage is intended for patients with conditions such as large or compressive goiters (eg, ≥80 g or dysphagia/dyspnea/hoarseness), hyperthyroidism when antithyroid therapy is ineffective/intolerable or contraindicated (including pregnancy/lactation), thyroid nodules, suspected/confirmed malignancy, or pertinent family history (eg, first‑degree relative with thyroid cancer or MEN2), but surgery is considered medically necessary only when clinical evaluation, imaging and biopsy support removal and one or more specified criteria are met and adjudication is subject to member-specific benefits.

"First-degree relative with thyroid cancer or multiple endocrine neoplasia type 2 (MEN2) syndrome"

Sign up to see full coverage criteria, indications, and limitations.