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Otolaryngology Coding Alert

Reader Questions:

Modifier 52 Requires Base Surgery

Question: I understood that 69450 (tympanolysis) is for time spent cleaning out a patient's badly infected ear, including removing granulation tissue and adhesions from the surface of the eardrum. After the cleaning, the physician usually applies silver nitrate cautery to the bleeding base. When I do not make  a postauricular incision and actually raise the tympanomeatal flap to get into the middle ear, can I still use this code, possibly with modifier 52?Ohio SubscriberAnswer: No. Because 69450 (Tympanolysis, transcanal) is a middle-ear procedure, you should not bill it with modifier 52 (Reduced services) if you did not enter the middle ear. Reserve modifier 52 for cases in which you partially reduce or eliminate a service or procedure but you still perform the basic service. This may involve a bilateral procedure that you did on only one side for various reasons.For instance, Medicare and most other carriers consider tonsillectomy a bilateral [...]

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