How To Use CPT Code 69100

CPT 69100 describes the procedure for biopsy of the external ear. This article will cover the official description, the detailed procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 69100?

CPT 69100 is used to describe the surgical removal of a part of abnormal tissue from the external ear, such as the earlobe or helix, for laboratory analysis. This procedure is performed to determine whether the lesion is malignant or benign.

2. Official Description

The official description of CPT code 69100 is the surgical removal of a portion of a lesion on the external ear for lab analysis.

3. Procedure

1. The patient is prepped and anesthetized, typically with a local anesthetic.
2. The provider selects the appropriate technique based on the depth of the lesion.
3. Using a special needle, biopsy punch, or blade, the provider removes a portion of the lesion.
4. Sutures are typically not required for this type of biopsy.
5. An antibiotic is applied to the surgical site and dressed.
6. The patient is observed for a short period and then released.
7. The specimen is sent to the laboratory for analysis.

4. Qualifying circumstances

CPT 69100 is performed when there is a need to remove a portion of abnormal tissue from the external ear for further analysis. The procedure is typically done to determine whether the lesion is malignant or benign. It is important to note that CPT 69100 includes the helix of the external ear.

5. When to use CPT code 69100

CPT code 69100 should be used when a provider performs a biopsy of the external ear to remove a portion of abnormal tissue for lab analysis. It is important to ensure that the procedure is documented accurately and meets the criteria for this specific code.

6. Documentation requirements

To support a claim for CPT 69100, the following documentation is required:

• Patient’s medical record, including the diagnosis and reason for the biopsy
• Description of the technique used for the biopsy
• Date of the procedure
• Details of the surgical site preparation and anesthesia administration
• Information about the specimen sent to the laboratory
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 69100, it is important to ensure that the documentation supports the medical necessity of the procedure. Modifier 51 can be appended to indicate multiple punch biopsies on the same claim, based on payer preferences. It is also important to note that CPT 69100 includes the helix, and for biopsy on the external ear canal, a different code should be used.

8. Historical information

CPT 69100 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a biopsy of the earlobe to analyze a suspicious lesion.
2. A patient undergoes a biopsy of the helix to determine the nature of an abnormal growth.
3. A provider removes a portion of a lesion on the external ear using a biopsy punch for further analysis.
4. A patient undergoes a biopsy of the external ear to evaluate a potentially malignant lesion.
5. A provider performs a biopsy of the ear to assess the presence of abnormal tissue.
6. A patient undergoes a biopsy of the external ear to determine the nature of a suspicious lesion.
7. A provider removes a portion of a lesion on the helix of the external ear for lab analysis.
8. A patient undergoes a biopsy of the earlobe to evaluate a potentially malignant growth.
9. A provider performs a biopsy of the external ear to assess the presence of abnormal tissue.
10. A patient undergoes a biopsy of the helix to determine the nature of a suspicious lesion.