How To Use CPT Code 69150

CPT 69150 describes the radical excision of an extensive lesion in the external auditory canal without neck dissection. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 69150?

CPT 69150 can be used to describe the surgical removal of an extensive lesion in the external auditory canal. This procedure is performed when the lesion becomes metastatic and starts invading other anatomical structures near or adjacent to the external ear.

2. Official Description

The official description of CPT code 69150 is: ‘Radical excision external auditory canal lesion; without neck dissection.’

3. Procedure

1. The provider approaches the external ear canal through an incision behind the ear, extending it to the front of the ear and all the way to the parotid gland in the cheek.
2. Surrounding structures are dissected around to gain access to the lesion.
3. The provider excises not only the external ear canal but also the parotid gland, tympanic membrane, and the ear bones (malleus, incus, and stapes) if necessary.
4. If required, a portion of the facial nerve and nearby supporting structures may also be removed.
5. The excised structures are removed en bloc, ensuring that all affected tissues are removed.
6. The incision is closed in layers, and a graft may be used for complete closure if necessary.
7. The ear is packed with gauze soaked in antibiotic solution and covered with a dressing.

4. Qualifying circumstances

CPT 69150 is performed when a lesion in the external auditory canal becomes metastatic and starts invading nearby anatomical structures. The procedure involves the excision of the external ear canal, parotid gland, tympanic membrane, ear bones, and potentially other structures if necessary. It does not include neck dissection.

5. When to use CPT code 69150

CPT code 69150 should be used when a provider performs a radical excision of an extensive lesion in the external auditory canal without neck dissection. It is important to accurately document the extent of the excision and ensure that the procedure aligns with the official description of the code.

6. Documentation requirements

To support a claim for CPT 69150, the provider must document the following information:

• Patient’s diagnosis and the need for the excision
• Extent of the lesion and structures involved
• Details of the surgical approach and technique used
• Date of the procedure
• Any additional procedures performed, such as grafting
• Post-operative care instructions
• Signature of the provider

7. Billing guidelines

When billing for CPT 69150, ensure that the procedure performed aligns with the official description of the code. It is important to accurately document the extent of the excision and any additional procedures performed. CPT code 69150 should not be reported with codes 69155 or any other codes related to neck dissection.

8. Historical information

CPT 69150 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 patient presents with an extensive lesion in the external auditory canal that has become metastatic. The provider performs a radical excision of the lesion without neck dissection (CPT 69150).
2. A lesion in the external auditory canal invades nearby structures, including the parotid gland and tympanic membrane. The provider performs a radical excision of the lesion without neck dissection (CPT 69150).
3. An extensive lesion in the external auditory canal requires the excision of the ear bones and a portion of the facial nerve. The provider performs a radical excision of the lesion without neck dissection (CPT 69150).
4. A patient’s lesion in the external auditory canal necessitates the removal of the parotid gland and surrounding structures. The provider performs a radical excision of the lesion without neck dissection (CPT 69150).
5. An extensive lesion in the external auditory canal requires the excision of the tympanic membrane and nearby supporting structures. The provider performs a radical excision of the lesion without neck dissection (CPT 69150).