January’s Thyroid Awareness Month may be behind us, but the conversation about thyroid health continues. February is National Self‑Check Month , a nationwide reminder that early detection begins with you — and checking your neck for a thyroid nodule is one of the easiest places to start. At Thyroid Nodule Treatment Center and Arizona Endocrine Surgery , we see every day how early awareness leads to better outcomes. Thyroid nodules are extremely common, often silent, and frequently discovered by accident. A simple monthly self‑check can help you notice changes early and take action with confidence. Why Thyroid Self‑Checks Matter Thyroid nodules are common — and often go unnoticed Most nodules don’t cause pain. Many don’t cause symptoms at all. A quick self‑check helps you spot changes before they become uncomfortable or visible. Early detection leads to better decisions Finding a nodule doesn’t mean something is wrong. Most are benign. But identifying one early allows for proper evaluation, monitoring, and — when appropriate — minimally invasive treatment options that preserve your thyroid. Self‑checks reduce uncertainty Patients often describe the relief of simply knowing what’s happening in their neck. A self‑check gives you a baseline and helps you recognize when something feels different. February is the perfect time to build the habit National Self‑Check Month encourages people to take ownership of their health. Adding a 30‑second neck check for a thyroid nodule to your routine is one of the easiest, most impactful habits you can adopt. How to Perform a Simple Thyroid Neck Check A thyroid self‑check takes less than a minute and can be done at home with a mirror and a glass of water. You’re looking for: A lump or bulge when you swallow Visible asymmetry in the lower neck A feeling of fullness or pressure Any new or persistent change in the contour of your neck To make this even easier, we’ve created a step‑by‑step guide you can download and share: 👉 Download the Thyroid Neck Check Guide    What to Do If You Find a Thyroid Nodule Finding a lump doesn’t automatically mean something is wrong — but it does mean it’s time for a professional evaluation. If your self‑check reveals something new — or if you’ve been told to “just watch it” but symptoms are getting harder to ignore — you deserve clarity and options. Ask your Primary Care Provider for an examination and request a referral to an endocrinologist, ENT or otolaryngologist. The endocrinologist, ENT or otolaryngologist will determine next steps and order labs and images Upon receiving the results, they may make a referral for you to Dr. Harding. At Thyroid Nodule Treatment Center within Arizona Endocrine Surgery, Dr. Richard Harding specializes in non‑surgical, minimally invasive treatments  for benign thyroid nodules, including: Radiofrequency Ablation (RFA) CellFx Nano‑Pulse Ablation (NPA) Microwave Ablation (MWA) These treatments shrink nodules without removing the thyroid, avoid general anesthesia, and leave no surgical scar. Your Thyroid Health Is in Your Hands — and We’re Here to Help National Self‑Check Month is a reminder that your health begins with awareness. A simple monthly neck check can help you catch changes early, reduce uncertainty, and open the door to treatments that preserve your thyroid and your quality of life. 👉 Download the Thyroid Neck Check Guide

At Arizona Endocrine Surgery, we specialize in the surgical treatment of conditions affecting the body’s hormone-producing glands. While many patients come to us through referrals from their endocrinologist or primary care provider, it’s important to understand why This article will help you to better understand the Arizona Endocrine Surgery referral process. What Conditions Does an Endocrine Surgeon Treat? Dr. Harding focuses on surgical solutions for disorders of the thyroid, parathyroid, adrenal glands, and certain endocrine tumors . Common conditions we evaluate and treat include: Thyroid nodules , goiters, or thyroid cancer requiring partial or total thyroidectomy Parathyroid gland disorders , such as primary hyperparathyroidism, often leading to surgery Adrenal tumors , including those producing excess hormones or suspicious for malignancy Neuroendocrine tumors  or endocrine metastases affecting the neck or abdomen Complex cases requiring reoperative endocrine surgery  or second opinions These conditions may be discovered through blood work, imaging, biopsies, or longstanding symptoms such as fatigue, weight changes, bone loss, or high calcium levels. Why a Referral Doesn’t Automatically Mean a Surgical Appointment Even if you’ve been referred to us by your provider, not every endocrine condition requires surgery . Endocrinologists are experts in diagnosis and medical management, and they often refer patients for surgical evaluation when imaging or lab results suggest that surgery might  be necessary. Steps to Requesting an Appointment However, before scheduling a consultation: Our team must first review your medical records, test results, and imaging reports. This helps us determine: Whether surgery is appropriate—or if additional tests or treatment may be needed first What treatment options are best matched to your needs How urgent the situation is and what documentation is still pending What Happens After Your Records Are Reviewed? Once we’ve reviewed your information, our office will: Contact you to confirm if a surgical consultation is appropriate Let you know if we need more records from your other providers Provide next steps for scheduling, including any preparation you may need before your visit This process ensures your time is respected , and that when you come in, we’re fully equipped to provide personalized, expert care. Request an appointment at Arizona Endocrine Surgery today For providers sending referrals Direct Message: To enable a more secure exchange of patient data than faxing, please join me via Updox at https://myupdox.com/updox-ui/dhtml/login.signup?code=rewind88909    Thank you,   rharding@hardingazendosurgery.kareodirect.com    HIPAA Secure Medical Records DM: rharding@hardingazendosurgery.kareodirect.com    Email to fax: DrHarding@m.medsender.com Fax Direct to medical staff: (949) 864-3166

Comparing Cutting Edge Nonsurgical Thyroid Treatments: RFA and nsPFA In a powerful episode of the Save Your Thyroid  podcast, host Jen welcomes renowned thyroid surgeon Dr. Richard Harding for a deep dive into two groundbreaking technologies revolutionizing thyroid nodule care—Radiofrequency Ablation (RFA) and the emerging frontrunner, Nanosecond Pulsed Field Ablation (NSPFA). What’s New in Thyroid Treatment? Dr. Harding shares how these minimally invasive procedures are shifting the paradigm away from traditional surgery. RFA, already well-established, uses thermal energy to treat benign nodules. NSPFA, however, is the rising star—harnessing ultrashort electric pulses to target tissue with remarkable precision and minimal thermal damage. That’s a major leap forward, especially when treating nodules near delicate structures like the recurrent laryngeal nerve.  Why NSPFA Is Generating Buzz NSPFA shines for its: Safety near critical anatomy , making it a game-changer for hard-to-reach nodules Shorter treatment times and reduced downtime Lower risk of vocal changes or damage Encouraging feedback from patients  who have embraced the non-surgical route Dr. Harding doesn’t just highlight the science—he brings real-world context from the clinic, discussing who makes ideal candidates, how outcomes compare, and what to expect during recovery. Eye on the Future The conversation also tackles important questions: Will NSPFA become the standard for benign thyroid nodules? Can it be used for malignant lesions down the line? How accessible are these treatments—and how do we balance innovation with cost? By the end of the episode, it’s clear: this isn’t just about new tools—it’s about reimagining thyroid care as more precise, patient-centered, and empowering. For Patients & Practitioners Whether you’re navigating treatment decisions or exploring clinical adoption, Dr. Harding offers thoughtful advice. His message is clear: informed choice is essential, and the best options are often those that preserve not just health—but quality of life. Watch the video Listen to the audio 00:00 Introduction to Thyroid Nodule Care 01:55 Understanding Radiofrequency Ablation (RFA) 05:12 Exploring Nanosecond Pulsed Field Ablation (NSPFA) 09:23 Safety and Precision in NSPFA 10:37 Treatment Duration and Patient Experience 17:28 Risks and Side Effects of NSPFA 19:02 Ideal Candidates for NSPFA 22:25 Patient Feedback and Outcomes 29:21 Exploring Treatment Modalities for Thyroid Nodules 31:50 Understanding Nodule Growth and Treatment Challenges 35:06 The Future of NSPFA in Thyroid Care 38:05 Cost and Accessibility of New Treatment Technologies 41:00 Potential for NSPFA in Treating Malignant Lesions 43:40 Advice for Patients with Thyroid Nodules 45:44 Guidance for Clinicians on Adopting New Techniques 48:20 Final Thoughts and Community Impact 55:42 Introduction to the Podcast and Resources Save your thyroid with Jen Cutting-Edge Thyroid Treatments: A Surgeon’s Perspective on RFA and nsPFA with Jen

For patients seeking radiofrequency ablation (RFA) as a treatment for thyroid nodules, insurance coverage has often been a hurdle. However, a recent New York State ruling has set a precedent that could change the landscape of thyroid care. A Victory for Thyroid Patients In a case reviewed by the New York State Department of Financial Services, an insurance company initially denied coverage for Thyroid Nodule radiofrequency ablation (RFA). This decision was later overturned, citing strong medical guidelines and peer-reviewed literature supporting the procedure. The ruling referenced the AACE/ACE/AME Medical Guidelines, which highlight radiofrequency ablation (RFA) as a less expensive and less invasive alternative to thyroid surgery—without the risks of cutaneous scarring or hypothyroidism. Why This Matters The decision emphasized that radiofrequency ablation (RFA) is clinically appropriate, aligns with accepted medical standards, and is not merely for convenience. It was determined to be the most appropriate level of care for the patient’s condition, reinforcing the argument that insurance providers should cover radiofrequency ablation (RFA) for thyroid nodules. The Benefits of Radiofrequency Ablation (RFA) for Thyroid Nodules RFA is a minimally invasive  procedure that uses radio waves to generate heat, effectively shrinking thyroid nodules. Unlike traditional surgery, radiofrequency ablation (RFA): Preserves thyroid function , reducing the risk of hypothyroidism. Avoids surgical scars , making it a cosmetically favorable option. Provides faster recovery , allowing patients to resume normal activities quickly. Effectively reduces nodule size , with studies showing a 50-80% shrinkage rate . Minimizes complications , with a permanent complication rate of less than 0.1% . Looking Ahead This ruling is a significant step toward broader insurance acceptance of RFA for thyroid nodules. Patients and healthcare providers can use this case as a reference when advocating for coverage. As more insurers recognize the benefits of RFA, access to this effective, minimally invasive treatment may become more widespread. For more information on thyroid nodule treatment options, visit the Thyroid Nodule Treatment Center . Read the Ruling online: New York Department of Financial Services official website header with case number reference 202203-147952. Ruling https://www.dfs.ny.gov/public-appeals/case-number-202203-147952 Print from website https://www.dfs.ny.gov/public-appeal/print-page/185341 Download the Ruling PDF Research cited in the ruling can be downloaded from the TNTC website : Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques Radiofrequency ablation and thyroid nodules: updated systematic review Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis Conventional thyroidectomy vs. thyroid thermal ablation on postoperative quality of life and satisfaction for patients with benign thyroid nodules The Clinical Utility of Minimally Invasive Interventional Procedures in the Management of Benign and Malignant Thyroid Lesions Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study) The Diagnosis and Management of Thyroid Nodules: A Review Radiofrequency Ablation for the Management of Thyroid Nodules: A Critical Appraisal of the Literature Thyroid Nodules Treated With Percutaneous Radiofrequency Thermal Ablation: A Comparative Study Radiofrequency Ablation for Autonomously Functioning Thyroid Nodules: A Multicenter Study Read more about this new ruling: https://bulletin.entnet.org/business-of-medicine-practice-management/article/22925883/two-new-cpt-codes-available-for-reporting-in-2025 https://starmed-america.com/thyroid-ablation-cpt-code/

Dr. Richard Harding Dr. Richard Harding explains the benefits of Thyroid Nodule RFA on the Sonoran Living segment of Arizona ABC15! Watch the video segment for a special offer from TNTC! Thyroid nodules commonly develop in humans and are variable in size, shape and location. Most of these growths are not cancer but may create symptoms of discomfort over time depending on the size, and location in the neck. Enlargement of the thyroid gland can commonly present with many symptoms including neck swelling, difficulty swallowing, neck pressure, choking, foreign body sensation, or simply a dry cough. Most patients experiencing such issues are sent to a surgeon for thyroid removal. Thyroid surgery is commonly performed safely and has its benefits for the patients; however, the removal of these abnormal glands also removes normal functioning thyroid tissue and produces a surgical scar. A non-surgical approach, Thyroid RFA, can now be performed to quickly alleviate these symptoms through a small skin puncture. This new technique involves applying high frequency electrical energy at the tip of a probe to produce a small focus of heat. Under ultrasound guidance, these probes can be advanced to the edges of the lesions. The abnormal tissue is destroyed safely with pinpoint accuracy. This process also protects the normal thyroid tissue and adjacent neck tissue. After 26 years of experience with thyroid ultrasound and thyroid surgery, Dr. Harding , a general and endocrine surgeon, has been performing thyroid RFA in selective patients at the Thyroid Nodule Treatment Center. He introduced this innovative procedure to Arizona in 2020. In addition, he has introduced numerous minimally invasive and robotic procedures in Arizona, including endoscopic transoral thyroidectomy. His success in these treatments has changed the lives of many. Evaluation for this thyroid RFA requires a neck ultrasound as well as a few thyroid biopsy tests. These are conveniently offered at the Thyroid Nodule Treatment Center location. Patients who have been reluctant to undergo thyroid removal now have an option to be treated with an office procedure that provides immediate relief. Patients suffering from huge nodules that push on the windpipe and create symptoms of choking and suffocation can quickly improve without surgical removal of the thyroid gland. Those patients experiencing trouble with swallowing as a result of a large nodule also improve dramatically as the thyroid shrinks in size. Patients enjoy not only seeing their neck swelling improve, but also avoid surgery, and the introduction of thyroid medication to their daily routine. The surgical scar and short-term recovery can be completely avoided. After a successful thyroid RFA procedure, periodic follow ups for thyroid nodular disease become celebrations of success. All of this is available at the Thyroid Nodule Treatment Center. About Dr. Richard Harding Dr. Harding is a member of distinguished organizations, including American Association of Endocrine Surgeons The American College of Surgeons Arizona Chapter American College of Surgeons Phoenix Surgical Society Maricopa County Medical Society Arizona Medical Association North American Society for Interventional Thyroidology Dr. Harding has taught residents in his role as Associate Professor in Surgery, Creighton University School of Medicine, Assistant Professor of Surgery, University of Arizona College of Medicine, and trainings he has provided on Thyroid Radiofrequency Ablation (RFA). Dr. Harding has dedicated a large part of his practice to endocrine surgery. He has performed over 2000 endocrine operations for adrenal, thyroid and parathyroid conditions. He is active in the American Association of Endocrine Surgeons. He is the first surgeon in the Southwest to perform a Transoral Endoscopic Thyroidectomy, which has the benefit of leaving no visible surgical scar. He is very familiar with the latest treatment guidelines for both thyroid and parathyroid diseases. He now also performs a Laparoscopic posterior adrenalectomy which significantly decreases recovery time for adrenal surgery conditions. For patients' convenience, many diagnostic tests and minor procedures can be performed in his office, including diagnostic ultrasound, ultrasound lymph node mapping, and ultrasound guided thyroid nodule biopsies. Dr. Harding also treats simple and complex hernias, gallbladder disease, colon cancer, diverticulitis, and gastroesophageal reflux conditions. He performs many abdominal wall reconstructions in patients who have complex hernia conditions, usually resulting from prior surgical procedures or prior failed ventral hernia repairs. Richard J. Harding, MD has been evaluating and removing hundreds of thyroid glands per year for the past twenty-eight years. He is very pleased to introduce a non-surgical treatment for large benign thyroid nodules. This new method applies internal energy to the thyroid nodules to effectively destroy problematic tissue without injuring the healthy outer thyroid gland. Dr. Richard Harding has performed 100 RFA treatments in the last 4 years.

Check your thyroid for nodules! January is Thyroid Awareness Month! The thyroid is a small gland responsible for producing hormones that play a crucial role in many of the body’s systems — from cells and tissues, to organs like the heart, brain, liver, and kidneys. The thyroid helps regulate and control things like metabolism - how your body uses energy. It also involves other processes like regulating body temperature, heart rate and blood pressure. Dysfunction occurs when the thyroid produces either too much or too little thyroid hormone. Either can disrupt healthy functioning of vital organs — leading to a wide range of symptoms. Thyroid Nodules: Unexpected Discoveries Everyday new thyroid nodules are discovered by their physicians, family, friends, and even their hairdressers! Some people have symptoms related to the size of the nodules, which directs them to seek medical consultation. Others have no symptoms but learn about these nodules after undergoing radiologic testing for different reasons. The majority of thyroid nodules are benign. Observe Thyroid Awareness Month! Take the Thyroid Neck Check Prepare : Grab a hand-held mirror and a glass of water. Position : Using the mirror, focus on the lower front area of your neck, above the collarbone, and below the voice box (larynx). This is where your thyroid gland is located. Perform the Check : Tip your head back, take a sip of water, and swallow. While swallowing, observe your neck in the mirror. Look for any bulges or protrusions. Remember, don't confuse the Adam's apple with the thyroid gland. Follow Up : If you notice any bulges, consult your physician. You might have an enlarged thyroid gland or a thyroid nodule. Share this flyer: Encourage Friends and Family to Get Tested If you know someone who frequently feels cold, has trouble sleeping, or experiences difficulty swallowing, it might be time to suggest they speak to their doctor about thyroid dysfunction. It's easy to overlook "small" issues like dry skin, but a thyroid test could lead to quicker treatment and better health outcomes. The most readily available modality for evaluating these is the ultrasound. The test is easily performed and avoids radiation exposure. The physician performed exam is much better than reviewing the still images saved on prior examinations. The study is easily repeated with no potential harm to the patient. Request an appointment at the Thyroid Nodule Treatment Center Expertise in RFA: Dr. Richard Harding's 100+ Successful Treatments TNTC's RFA thyroid nodule volume reduction results Patient Success Stories With thyroid ultrasound there are several features in benign nodules that we like to identify to consider a lesion low risk of malignancy. When some of these features are absent, the nodule would be considered indeterminate, or potentially at risk for malignancy. These nodules will be tested using a biopsy to help the physician guide therapy. Not all nodules have the favorable ultrasound characteristics, and yet they may prove benign on biopsy. Additionally, a small percentage of nodules can have favorable findings on ultrasound and yet can be found to have papillary thyroid cancer. It is for these reasons that routine surveillance ultrasound is initiated once a nodule grows to about 15 mm in largest dimension. Dr. Richard Harding is an exceptional surgeon specializing in endocrinology: Pioneering Techniques : Dr. Harding has introduced several innovative surgical techniques, including endoscopic transoral thyroidectomy, which leaves no visible scar, and radiofrequency ablation (RFA) for thyroid nodules. He was the first surgeon in Arizona to perform thyroid RFA and now also provides CellFX nsPFA treatment. Minimally Invasive Focus : He specializes in minimally invasive surgery, which allows for quicker recovery times, less scarring, and reduced pain for patients. His expertise spans various endocrine conditions, including thyroid, parathyroid, and adrenal surgeries. Extensive Experience : With over 30 years of experience in thyroid surgery and more than 25 years of performing minimally invasive procedures, Dr. Harding has honed his skills to provide the best possible outcomes for his patients. Comprehensive Care : Dr. Harding performs many diagnostic tests and minor procedures in his office, such as ultrasound-guided thyroid nodule biopsies, which allows for personalized and comprehensive care tailored to each patient's specific needs. Educational Contributions : He is a regional instructor and has been involved in teaching other surgeons his techniques, contributing to the advancement of the field. Recognition and Awards : Dr. Harding has been recognized for his excellence in surgery, including being voted Top Doctor by Phoenix Magazine and receiving the Surgeon of Excellence in Robotic Surgery award. Download TNTC Thyroid Self Check flyer PDF Press Release

The 2025 CPT codes have a disappointing effect on insurance coverage for patients receiving thyroid nodule radiofrequency ablation (RFA). American Medical Association (AMA) RVS Update Committee (RUC) In January 2024, the American Medical Association (AMA) RVS Update Committee (RUC) evaluated two new reporting codes for valuation: 60660 for percutaneous radiofrequency ablation of thyroid nodules and 60661 as an add-on code for additional nodule(s). The Centers for Medicare & Medicaid Services (CMS) suggested adopting the RUC’s recommended values in the proposed CY 2025 Medicare Physician Fee Schedule (MPFS). Here are the key changes: New CPT Codes : Two new codes have been introduced specific to radiofrequency ablation techniques for thyroid nodules. The second code is reported only when additional lobes are treated. CPT code 60660  covers the ablation of one or more thyroid nodules in a single lobe or the isthmus, including imaging guidance. CPT code 60661  is an add-on code for the ablation of additional nodules in another lobe, including imaging guidance, radiofrequency. Valuation and Reimbursement : The Centers for Medicare & Medicaid Services (CMS) have accepted the recommended work Relative Value Units (RVUs) for these codes. This means that the reimbursement rates for these procedures have been updated to reflect their complexity and resource requirements. Single Use Limitation : CMS has directed that these codes be used only once per treatment session, regardless of the number of nodules treated in each lobe. This is different from previous codes for biopsy procedures, which allow separate reporting for each lesion. Impact on Billing Procedure : These changes aim to streamline the coding and billing process, ensuring that patients receive appropriate reimbursement for their treatments. The new codes are intended to standardize the reporting of thyroid nodule RFA procedures, making it easier for healthcare providers to document and bill for these services accurately. Impact on Insurance Coverage Over the last 5 years, numerous patients have been anticipating the development of this code to seek treatment with insurance coverage benefits. The assignment of specific CPT codes represents acceptance of thyroid RFA as a procedural payment for the providing physician in an outpatient practice. Overall, the new CPT codes are designed to improve the accuracy and efficiency of billing for thyroid nodule RFA procedures. Ultimately this has negligible benefit to patients who will be required to supplement their insurance coverage in order to receive desirable, non-surgical alternatives to treat thyroid nodules and to preserve their thyroid functioning without requiring medication for the rest of their lives. As of January 2025, the assignment of specific CPT® codes for percutaneous Radiofrequency Ablation of Thyroid Nodules represents acceptance of thyroid RFA as a procedural payment for the providing physician in an outpatient practice. Read more:

The North American Society for Interventional Thyroidology (NASIT) forwards innovation, collaboration and progress, in addition to physician and patient education. NASIT is a multidisciplinary group of physicians interested in Interventional Thyroidology with a two-fold mission: To promote safe integration of ablative technologies into clinical practice  To promote a collaborative environment that supports education and research efforts in Interventional Thyroidology  Dr. Richard Harding has been serving as the Program Chair for NASIT Annual Meetings. This year, Dr. Harding is presenting a session on Perithyroid and Deep Cervical Block, as well as sitting on the panel discussing key technologies in the field. NASIT 2024 Program Agenda Dr. Harding is delighted to reconnect with colleagues at the Annual Meeting in Sarasota, Florida. In addition to serving as the Program Chair for NASIT, Dr. Harding is a member of distinguished organizations, including American Association of Endocrine Surgeons The American College of Surgeons Arizona Chapter American College of Surgeons Phoenix Surgical Society Maricopa County Medical Society Arizona Medical Association Dr. Harding has taught residents in his role as Associate Professor in Surgery, Creighton University School of Medicine, Assistant Professor of Surgery, University of Arizona College of Medicine, and trainings he has provided on Thyroid Radiofrequency Ablation (RFA). Dr. Harding has dedicated a large part of his practice to endocrine surgery. He has performed over 2000 endocrine operations for adrenal, thyroid and parathyroid conditions. He is active in the American Association of Endocrine Surgeons. He is the first surgeon in the Southwest to perform a Transoral Endoscopic Thyroidectomy, which has the benefit of leaving no visible surgical scar. He is very familiar with the latest treatment guidelines for both thyroid and parathyroid diseases. He now also performs a Laparoscopic posterior adrenalectomy which significantly decreases recovery time for adrenal surgery conditions. For patients' convenience, many diagnostic tests and minor procedures can be performed in his office, including diagnostic ultrasound, ultrasound lymph node mapping, and ultrasound guided thyroid nodule biopsies. Dr. Harding also treats simple and complex hernias, gallbladder disease, colon cancer, diverticulitis, and gastroesophageal reflux conditions. He performs many abdominal wall reconstructions in patients who have complex hernia conditions, usually resulting from prior surgical procedures or prior failed ventral hernia repairs. Richard J. Harding, MD has been evaluating and removing hundreds of thyroid glands per year for the past twenty-eight years. He is very pleased to introduce a non-surgical treatment for large benign thyroid nodules. This new method applies internal energy to the thyroid nodules to effectively destroy problematic tissue without injuring the healthy outer thyroid gland. Dr. Richard Harding has performed over 90 RFA treatments in the last 4 years.

Currently the evaluation of the thyroid nodules is covered by insurance companies. However, radiofrequency ablation of thyroid nodules is new and is not considered a recognized benefit. As the exciting success of thyroid RFA is recognized, the insurance companies are paying and reimbursing more frequently. This therapy will save the patient and the entire healthcare system a considerable amount of money. As the healthcare community and patients continue to advocate for this non-surgical solution of benign thyroid nodules, the availability to utilize insurance healthcare benefits will increase. The American Association of Endocrine Surgeons and Society of Interventional Radiology are both working towards getting this valuable treatment more readily accepted by more insurance companies You can demand an appeal to an insurance coverage denial. TNTC has gathered the following suggestions and background material to assist you. These resources are also available on our Insurance Page . Suggestions to appeal insurance denial How to Appeal Denied Claims from the National Association of Insurance Commissioners Insurance Authorization Letter for Radiofrequency Ablation of the Thyroid Gland from the Thyroid Nodule Treatment Center. Ultrasound Guided Radiofrequency Ablation (RFA) of the Thyroid Gland Understanding Insurance Coverage Arizona Guidelines for Health Claim Appeal

January is Thyroid Awareness Month! The thyroid is a small gland responsible for producing hormones that play a crucial role in many of the body’s systems — from cells and tissues, to organs like the heart, brain, liver, and kidneys. The thyroid helps regulate and control things like metabolism - how your body uses engery. It also involves other processes like regulating body temperature, heart rate and blood pressure. Dysfunction occurs when the thyroid produces either too much or too little thyroid hormone. Either can disrupt healthy functioning of vital organs — leading to a wide range of symptoms. Everyday new thyroid nodules are discovered by their physicians, family, friends, and even their hairdressers! Some people have symptoms related to the size of the nodules, which directs them to seek medical consultation. Others have no symptoms but learn about these nodules after undergoing radiologic testing for different reasons. The majority of thyroid nodules are benign. The most readily available modality for evaluating these is the ultrasound. The test is easily performed and avoids radiation exposure. The physician performed exam is much better than reviewing the still images saved on prior examinations. The study is easily repeated with no potential harm to the patient. With thyroid ultrasound there are several features in benign nodules that we like to identify to consider a lesion low risk of malignancy. When some of these features are absent, the nodule would be considered indeterminate, or potentially at risk for malignancy. These nodules will be tested using a biopsy to help the physician guide therapy. Not all nodules have the favorable ultrasound characteristics, and yet they may prove benign on biopsy. Additionally, a small percentage of nodules can have favorable findings on ultrasound and yet can be found to have papillary thyroid cancer. It is for these reasons that routine surveillance ultrasound is initiated once a nodule grows to about 15 mm in largest dimension. Dr. Richard Harding has performed over 90 RFA treatments in the last 3 years.

The authors of a recent study, “Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules—Expanding Treatment Options in the United States,” published in the Journal of the Endocrine Society, found that RFA is safe and effective for treating benign thyroid nodules that cause problems due to their size or function. RFA is less risky than surgery and radioactive iodine, and it helps keep your thyroid working properly. In this study, doctors looked at how well radiofrequency ablation (RFA) worked for people with thyroid nodules. The study was done by reviewing the charts of patients who had RFA for their thyroid nodules at The Thyroid Clinic in Salt Lake City, Utah between November 2018 and January 2021. All patients had a physical exam, blood tests for thyroid function, and thyroid ultrasound before the procedure. Patients who had suspicious findings on the ultrasound had a thyroid biopsy. Patients who had metal hardware/ pacemaker, pregnancy, or suspicious results on fine-needle aspiration biopsy were not treated with RFA procedure. The nodules that were producing too much thyroid hormone causing hyperthyroidism and nodules that were mostly solid and were bothersome due to their size causing pressure in the neck and choking symptoms or cosmetic concerns were treated with RFA. The doctors found that RFA was successful in shrinking the nodules in most patients. In fact, the average decrease in size was 70% on initial evaluation. The volume of the smaller nodules decreased more than the larger nodules. Thyroid blood tests and hyperthyroid symptoms improved in the nodules making too much thyroid hormone. Thyroid function tests remained normal in the nodules that were treated due to size. There were no major complications. Thyroid nodules are small lumps that can grow in the thyroid gland, which is located in the neck. They are common and can be found in more than half of the population in the United States. Most of the time, they do not cause any problems. However, some nodules can be cancerous and require surgery. If the nodule is not cancerous, it can still cause problems if it grows too large and causes discomfort or changes the appearance of the neck. Another situation that can be harmful is when the nodule produces too much thyroid hormone, which can cause hyperthyroidism. In these cases, doctors may recommend surgery or radioactive iodine therapy to remove or shrink the nodule. Both treatments have some risks, such as hypothyroidism, which means that you may need to take thyroid hormone replacement pills for the rest of your life. Surgery can also leave a scar and sometimes affect your voice. In recent years, doctors have been using new treatments to help people with thyroid nodules. One of these treatments is called radiofrequency ablation (RFA). During RFA, a thin needle is inserted into the nodule under ultrasound guidance. Then, an electrical current passes through the needle, which generates heat and burns the cells inside the nodule. This causes the nodule to shrink and turn into scar tissue. The best part is that this procedure can be done in the doctor’s office without putting you to sleep with general anesthesia. However, only a few doctors in the United States are experts in administering this treatment. Dr. Richard Harding has performed over 90 RFA treatments in the last 3 years. Cited Research Hussain I, Zulfiqar F, Li X, Ahmad S, Aljammal J. “Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules—Expanding Treatment Options in the United States.” Journal of the Endocrine Society, vol. 5, no. 8, Aug. 2021, p. bvab110. DOI.org (Crossref), https://doi.org/10.1210/jendso/bvab110.

The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. Dr. Richard Harding has been an American College of Surgeons Fellow since 1998. The American College of Surgeons (ACS) is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. Members of the ACS are referred to as "Fellows." The letters FACS (Fellow, American College of Surgeons) after a surgeon's name mean that the surgeon's education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College. Attending the American College of Surgeons Clinical Congress events in Boston, Dr. Harding is delighted to reconnect with residents that he has trained over the years as well as many colleagues from the professional organizations he is a member of. Dr. Harding has taught residents in his role as Associate Professor in Surgery, Creighton University School of Medicine, Assistant Professor of Surgery, University of Arizona College of Medicine, and trainings he has provided on Thyroid Radiofrequency Ablation (RFA). In addition to being a Fellow of the American College of Surgeons , Dr. Harding is also a member of other surgery organizations including North American Society for Interventional Thyroidology American Association of Endocrine Surgeons Arizona Chapter American College of Surgeons Phoenix Surgical Society Maricopa County Medical Society Arizona Medical Association Dr. Harding has dedicated a large part of his practice to endocrine surgery. He has performed over 2000 endocrine operations for adrenal, thyroid and parathyroid conditions. He is active in the American Association of Endocrine Surgeons. He is the first surgeon in the Southwest to perform a Transoral Endoscopic Thyroidectomy, which has the benefit of leaving no visible surgical scar. He is very familiar with the latest treatment guidelines for both thyroid and parathyroid diseases. He now also performs a Laparoscopic posterior adrenalectomy which significantly decreases recovery time for adrenal surgery conditions. For patients' convenience, many diagnostic tests and minor procedures can be performed in his office, including diagnostic ultrasound, ultrasound lymph node mapping, and ultrasound guided thyroid nodule biopsies. Dr. Harding also treats simple and complex hernias, gallbladder disease, colon cancer, diverticulitis, and gastroesophageal reflux conditions. He performs many abdominal wall reconstructions in patients who have complex hernia conditions, usually resulting from prior surgical procedures or prior failed ventral hernia repairs. Richard J. Harding, MD has been evaluating and removing hundreds of thyroid glands per year for the past twenty-eight years. He is very pleased to introduce a non-surgical treatment for large benign thyroid nodules. This new method applies internal energy to the thyroid nodules to effectively destroy problematic tissue without injuring the healthy outer thyroid gland. Let the most experienced thyroid surgeon in Arizona Save Your Thyroid!