Camille Posted Mon 30th of December, 2019 17:25:08 PM
Provider performs revision of complete mastoidectomy, ossicular chain reconstruction and synthetic prosthesis PORP, and a revision tympanoplasty. Does CPT 69637 capture all 3 of these components correctly? Thank you very much!
SuperCoder Answered Tue 31st of December, 2019 06:11:05 AM
Thank you for your question
CPT® code 69637 covers all the components, i.e. Tympanoplasty, ossicular chain reconstruction and synthetic prosthesis (PORP) and mastoidectomy, but it does not indicate the revision part.
More appropriate code for the above-mentioned scenario will be CPT® code 69633 (Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
and CPT® code 69604 (Revision mastoidectomy; resulting in tympanoplasty). The above codes indicate the revision mastoidectomy and revision tympanoplasty.
Note: Append modifier 52 (Reduced Services) along with CPT® code 69604, as the tympanoplasty procedure has already been covered up in CPT® code 69633.
Hope that helps!