Wiki CPT Code for Earwell?

[stephanieconn67]

Hi! I am hoping someone might have success in billing for an earwell. We have been using unlisted code 21089, but this is not accurate since an earwell is not a prosthetic, it's an ear mold that is placed temporarily to reshape the external ear. I'm wondering about 69399, another unlisted, but it seems more fitting than the other. Any ideas or suggestions would be appreciated. Thank you!

 

[FractalMind]

Hi! I am hoping someone might have success in billing for an earwell. We have been using unlisted code 21089, but this is not accurate since an earwell is not a prosthetic, it's an ear mold that is placed temporarily to reshape the external ear. I'm wondering about 69399, another unlisted, but it seems more fitting than the other. Any ideas or suggestions would be appreciated. Thank you!

Hi Stephanie,
Did you figure out which CPT to use for earwell splint?

 

[bkhattak]

We use 21086 for Earwell and get paid.

 

[Cynthia Hughes]

The payer may give you direction on this as in this example from Anthem (https://www.anthem.com/dam/medpolicies/abcbs_va/active/guidelines/gl_pw_e002882.html). Code 69399 meets CPT criteria that you select the code that instructs not to select a code that merely approximates a procedure but use an unspecified code when no specific code exists. Getting paid is not the verification that the service was correctly reported. I hope this helps.
Cindy