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Otolaryngology Coding Alert

Reader Question:

Cut Out Graft Confusion

Published on Tue Apr 01, 2003

Question: When the doctor performs 69631, should I bill for a temporalis fascia graft? And how should I code that? Or is it included in 69631? New York Subscriber Answer: Tympanoplasty (69631, Tympanoplasty without mastoidectomy [including canalplasty, atticotomy and/or middle ear surgery], initial or revision; without ossicular chain reconstruction) includes a graft from the same side. You can bill for the temporalis fascia graft separately, however, if the otolaryngologist harvests the graft through a separate incision from a different side. Agraft from the temporalis fascia, a sheet of fibrous tissue that covers the temporal muscle in the jaw, includes tissue only. Therefore, the correct code for the graft is 20926 (Tissue grafts, other [e.g., paratenon, fat, dermis]). You should not attach a modifier to 20926 because CPT designates the code as modifier -51 (Multiple procedures) exempt. This status does not make 20926 an add-on code, but it does exempt the graft from the multiple-procedure discount.  
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