Wiki Fabrication and Application of Thermoplastic Ear Splint (i.e. Ear Molding) for Stahl's Ear

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Mark Sonomura

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Here's a challenge for you experienced Plastic Surgery Coders! My plastic surgeon saw a 5-week-old male with bilateral abnormal scaphoid folding with resulting Stahl's Ear contour. He determined that cartilage molding is possible, given child's early age, and could improve the overall appearance of the ears. He proceeded with ear molding, by fabricating and applying thermoplastic splints. Does anyone know of any CPT and/or HCPCS Codes that could be used to report the Supply, Fabrication and/or Application of the Ear Splint? Will I have to resort to Unlisted Procedure Codes, or are there actually Specific Codes that would apply? I would appreciate any suggestions. Thanks!
 
I did a little more research and found a Super Coder article from 2019 with a Q&A that ruled out 21086 (Impression and custom preparation; auricular prosthesis) and recommended 69399 (Unlisted procedure, external ear). We went with the recommendation and reported 69399, decided 29130 (Application of finger splint; static) was comparable in terms of work, and set up our fee, accordingly. We weren't able to get this paid, though. The payer determined the service was not covered. Better luck to you if you decide to try the same approach! But I think most payers are going to going to see this as a non-covered service, as well.
 
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