Otolaryngology Coding Alert

Question: An otolaryngologist performs a canalplasty with osteoma excision. Should I report 69310 because the patient has stenosis due to the osteoma, or would 69140 be more appropriate? Illinois Subscriber Answer: You should select the code based on whether the otolaryngologist reconstructed the external auditory canal, not the patient's condition (which, in this case, is stenosis). If the otolaryngologist made the incision, removed the osteoma, and replaced the skin, you should report 69140 (Excision exostosis[es], external auditory canal). But if he performed a "plasty," such as drilling the bony canal or attaching skin grafts, you should assign 69310 (Reconstruction of external auditory canal [meatoplasty] [e.g., for stenosis due to injury, infection] [separate procedure]).