Myringoplasty and foreign body removal

[AN2114]

The doctor removed a foreign body in the ear and did a myringoplasty since the foreign body caused a tympanic membrane perforation. Can I code 69610 with 69205? I don't see anything in the NCCI edits that I can't but I'm unsure if I can since it is in the same ear? Any thoughts?

Thanks!

 

[jackjones62]

Based on everything I have read, coding 69610 only would be your best option. The code descriptive indicates repair with or without site preparation, removing the foreign body could be considered "site preparation" just like removing a PE tube or cerumen, it's inclusive to the repair and not separately payable. You are correct that there is no CCI edits between these two codes and you could try to bill them together, but my ENT experience (27yrs) tells me they will most likely view this situation in a similar way and deny 69205 as bundled.

Jennifer
Coding Analyst

 

[AN2114]

Based on everything I have read, coding 69610 only would be your best option. The code descriptive indicates repair with or without site preparation, removing the foreign body could be considered "site preparation" just like removing a PE tube or cerumen, it's inclusive to the repair and not separately payable. You are correct that there is no CCI edits between these two codes and you could try to bill them together, but my ENT experience (27yrs) tells me they will most likely view this situation in a similar way and deny 69205 as bundled.

Jennifer
Coding Analyst

Thank you!