How To Use CPT Code 69105

CPT 69105 describes the procedure for biopsy of the external auditory canal, which is the part of the ear between the outer opening and the ear drum. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 69105?

CPT 69105 is used to describe the surgical removal of a part of abnormal tissue from the external auditory canal. This procedure is performed by a healthcare provider to determine whether the lesion is malignant or benign. The provider removes a portion or the entirety of the lesion on the external ear, typically using techniques such as shaving it off or incising around the lesion and cutting it out with a scalpel. Stitches are usually not required for this type of biopsy. An antibiotic is applied to the surgical site, and the patient is observed for a short period before being released. The specimen is then sent to the laboratory for analysis.

2. Official Description

The official description of CPT code 69105 is: ‘Biopsy external auditory canal.’

3. Procedure

1. The patient is appropriately prepped and anesthetized, usually with local anesthetic.
2. The healthcare provider chooses among several techniques to remove a portion or the entirety of the lesion on the external ear.
3. Depending on the depth of the lesion, the provider may shave it off or incise around the lesion and cut it out with a scalpel.
4. Stitches are typically not required for this type of biopsy.
5. An antibiotic is applied to the surgical site, and it is dressed.
6. The patient is observed for a short period before being released.
7. The specimen is sent to the laboratory for analysis.

4. Qualifying circumstances

CPT 69105 is performed when there is a need to biopsy abnormal tissue in the external auditory canal. The procedure is typically done to determine whether the lesion is malignant or benign. The patient must be appropriately prepped and anesthetized, and the biopsy is performed by a healthcare provider. The biopsy may involve shaving off the lesion or incising around it and cutting it out with a scalpel. Stitches are usually not required for this type of biopsy.

5. When to use CPT code 69105

CPT code 69105 should be used when a healthcare provider performs a biopsy of the external auditory canal to remove abnormal tissue. This code is appropriate when the procedure involves the removal of a portion or the entirety of the lesion on the external ear. It is important to note that CPT code 69105 is specifically for the external auditory canal and should not be used for biopsies of other external ear structures, such as the earlobe, helix, or auricle, which have their own specific codes.

6. Documentation requirements

To support a claim for CPT 69105, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the biopsy
• Details of the procedure performed, including the technique used
• Any complications or additional procedures performed
• Date of the procedure
• Start and end time of the procedure
• Any relevant findings or observations
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 69105, ensure that the procedure involves the biopsy of the external auditory canal. It is important to use the correct code for biopsies of other external ear structures, such as the earlobe, helix, or auricle. Modifier 51, Multiple procedures, may be appended to additional biopsies on the same claim, depending on payer preferences. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 69105 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs a biopsy of the external auditory canal to remove a suspicious lesion for analysis.
2. During the procedure, the provider shaves off a portion of the abnormal tissue in the external ear to determine whether it is malignant or benign.
3. A patient undergoes a biopsy of the external auditory canal to remove a lesion and send it to the lab for analysis.
4. The healthcare provider incises around the abnormal tissue in the external ear and cuts it out with a scalpel for further examination.
5. A biopsy of the external auditory canal is performed to remove a suspicious growth and determine its nature.
6. The provider removes a portion of the lesion on the external ear using a scalpel during the biopsy procedure.
7. A patient undergoes a biopsy of the external auditory canal to remove a suspicious area and send it for pathological analysis.
8. The healthcare provider performs a biopsy of the external auditory canal to remove a lesion and determine whether it is cancerous or not.
9. During the procedure, the provider excises the abnormal tissue in the external ear to send it to the lab for evaluation.
10. A patient undergoes a biopsy of the external auditory canal to remove a growth and determine its characteristics.