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Wiki Surgery help for BAHA abutment only removal

Wendy0715

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Hello!

I have a question regarding the cpt code to use for when the doctor removes only the abutment of the BAHA and the implant stays in place. He then removes granulation tissue and closes the site. I was thinking to use an unlisted code and compare it to 20680 and then using 11442 and 12051 for the second part. Thoughts please!!

Before prepping and draping the surgical site, we began by removing the existing BAHA abutment. Using the BAHA screwdriver and counter torque wrench, we loosened the central coupling screw and removed the abutment from the scalp, leaving the osseointegrated implant in place. We then prepped and sterilely draped the surgical site in the usual fashion for ear surgery.
We then turned our attention to excising the scar tissue/granulation tissue from the abutment site. Using a 15-blade scalpel, we excised a ~2 cm ellipse from around the abutment site. We undermined the adjacent subcutaneous tissue to allow for a low-tension closure, again, being careful to avoid creating a communication between the subperiosteal pocket and the BAHA site. After obtaining local hemostasis, we closed the wound in a multilayered fashion using 3-0 Vicryl sutures to reapproximate the subcutaneous tissues, and a 3-0 chromic suture thrown in horizontal mattress fashion to reapproximate the skin.
 
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