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Left radical external auditory canal lesion removal

Sherry Posted Mon 18th of April, 2011 18:46:29 PM

Once the ear canal skin was widely incised, the Duckbill and round knife elevators wwere then used to elevate the periosteum directly over the bone. the incision was from the edge of the conchal cartilage, including a small portion of conchal cartilage posteriorly within the anterior portion of the ear canal anteriorly and from the tympanomastoid to tympanosquamous suture line superiorly and inferiorly. This allowed complete removal of the lesion with the underlying periosteum. The bone within the ear canal was very thin and it was felt that drilling in this area would risk performation of the mastoid cavity. A full thickness skin graft was then harvested from the left upper neck along a natural skin crease.
I was told 69150, but no bone was excised...

SuperCoder Answered Mon 18th of April, 2011 20:29:58 PM

In 69150, depending upon whether the lesion involves bone, a section of supporting hard tissue may be excised.

In the above question, there is removal of the lesion(within the underlying periosteum) which involves the incision of "periosteum" that is directly over the bone. So, 69510 would not be wrong.

Sherry Posted Tue 19th of April, 2011 13:09:26 PM

Since he didn't excise bone, I had thought of using 69150 with a -52 modifier (reduced services).
Nearby supporting structures (eg, part of the lower jaw bone and temporal bone protrusion) are also removed in the same surgical session.
Thanks for your response.

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