How To Use CPT Code 69660

CPT 69660 describes a surgical procedure that involves the removal of the stapes bone in the middle ear, known as stapedectomy, or the creation of an opening in the bone, known as stapedotomy. This procedure aims to reestablish ossicular continuity, improve the mobility of the stapes, and enhance hearing. In this article, we will explore the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes related to CPT 69660.

1. What is CPT Code 69660?

CPT 69660 is a code used to describe a surgical procedure that involves the removal of the stapes bone in the middle ear, known as stapedectomy, or the creation of an opening in the bone, known as stapedotomy. This procedure aims to reestablish ossicular continuity, increase the mobility of the stapes, and improve hearing. It is typically performed by a qualified healthcare professional in a surgical setting.

2. Official Description

The official description of CPT code 69660 is: ‘Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material.’

3. Procedure

1. The healthcare professional begins by appropriately prepping and anesthetizing the patient.
2. An incision is made in the posterior ear canal via the ear canal opening, or a postauricular incision may be used.
3. The provider uses microscopic visualization to move the skin flap and posterior eardrum forward.
4. If necessary, a portion of the bony canal may be removed using a curette or drill.
5. The provider identifies and moves the ossicular chain, specifically separating the stapes from the incus.
6. Depending on the specific case, the provider either removes the stapes (stapedectomy) or drills a small hole in the stapes footplate using a laser or drill (stapedotomy).
7. If a stapedectomy is performed, a prosthetic replacement is placed on the incus, and a piece of fascia, vein, perichondrium, or fat may be used to stabilize the prosthesis.
8. The canal skin flap and eardrum are repositioned, and the ear canal is packed.

4. Qualifying circumstances

CPT 69660 is typically performed on patients who require the reestablishment of ossicular continuity and improvement in hearing. The procedure is indicated for individuals with specific middle ear conditions that affect the mobility of the stapes bone. These conditions may include otosclerosis, congenital malformations, or traumatic injuries. The procedure is performed by a qualified healthcare professional in a surgical setting.

5. When to use CPT code 69660

CPT code 69660 should be used when a qualified healthcare professional performs a stapedectomy or stapedotomy procedure to reestablish ossicular continuity and improve hearing. It is important to note that this code should not be used for cases involving footplate drill out, revisions of previous stapedectomy or stapedotomy procedures, or other related procedures. It is crucial to accurately document the specific procedure performed to ensure proper coding and billing.

6. Documentation requirements

When reporting CPT code 69660, the healthcare professional must ensure that the documentation includes the following information:

• Patient’s diagnosis and the need for stapedectomy or stapedotomy
• Details of the procedure performed, including whether it was a stapedectomy or stapedotomy
• Specific techniques used during the procedure, such as the use of foreign material
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 69660, it is important to ensure that the procedure was performed by a qualified healthcare professional and that the documentation supports the specific details of the procedure. It is also essential to follow any specific guidelines provided by the payer or coding guidelines. Additionally, it is important to note that there are other related codes for different variations of the procedure, such as footplate drill out or revisions of previous procedures, which should be used when appropriate.

8. Historical information

CPT code 69660 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A qualified healthcare professional performs a stapedectomy to reestablish ossicular continuity and improve hearing in a patient with otosclerosis.
2. During a stapedotomy procedure, the provider creates an opening in the stapes footplate to enhance the mobility of the stapes bone and improve hearing in a patient with congenital malformations.
3. A surgical team performs a stapedectomy to remove the stapes bone and replace it with a prosthetic device in a patient with traumatic injuries to the middle ear.
4. In a stapedotomy procedure, the provider drills a small hole in the stapes footplate using a laser to improve the transmission of sound vibrations in a patient with conductive hearing loss.
5. A qualified healthcare professional performs a stapedectomy to reestablish ossicular continuity and improve hearing in a patient with otosclerosis and significant hearing impairment.
6. During a stapedotomy procedure, the provider creates an opening in the stapes footplate using a drill to improve the mobility of the stapes bone and enhance hearing in a patient with congenital middle ear abnormalities.
7. A surgical team performs a stapedectomy to remove the stapes bone and replace it with a prosthetic device in a patient with a history of chronic ear infections and conductive hearing loss.