How To Use CPT Code 69666

CPT 69666 describes the repair of an oval window fistula, which is an abnormal connection between two organs or vessels in the inner ear. 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 69666?

CPT 69666 can be used to describe the repair of an oval window fistula, a condition where there is an abnormal connection between two organs or vessels in the inner ear. This code is used when a healthcare provider performs a surgical procedure to terminate the connection and prevent fluid leakage.

2. Official Description

The official description of CPT code 69666 is: ‘The provider repairs an oval window fistula, or abnormal connection between two organs or vessels, in the inner ear, which often results in a fluid leak.’

3. Procedure

1. The healthcare provider creates an incision in the posterior ear canal or behind the ear.
2. Using magnification tools like a microscope or loupes, the provider carefully dissects the area.
3. A skin flap is created, and the posterior eardrum is moved out of the way.
4. The provider inspects the oval window fistula for a fluid leak and roughens the lining of the oval window.
5. The oval window area is packed with fat, fascia, or muscle tissue to terminate the connection between the two areas.
6. The eardrum and skin flap are replaced, and the ear canal is packed.
7. If performed, the postauricular incision is sutured.

4. Qualifying circumstances

Patients eligible for CPT 69666 are those with an oval window fistula, which is an abnormal connection between two organs or vessels in the inner ear. The procedure is performed to repair the fistula and prevent fluid leakage. The healthcare provider must carefully assess the patient’s condition and determine the need for surgical intervention.

5. When to use CPT code 69666

CPT code 69666 should be used when a healthcare provider performs a surgical repair of an oval window fistula. This code is specific to the repair of this particular type of fistula and should not be used for other types of repairs or procedures.

6. Documentation requirements

To support a claim for CPT 69666, the healthcare provider must document the following information:

• Patient’s diagnosis of an oval window fistula
• Description of the surgical repair procedure performed
• Date of the procedure
• Details of the incision and dissection
• Confirmation of termination of the connection between the organs or vessels
• Replacement of the eardrum and skin flap
• Details of any additional procedures performed, such as suturing the postauricular incision
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 69666, ensure that the procedure performed is a repair of an oval window fistula. Use the appropriate CPT code based on the specific procedure performed. It is important to review the documentation and accurately select the correct code to avoid any billing errors or denials.

8. Historical information

CPT 69666 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 healthcare provider performs a surgical repair of an oval window fistula in a patient with a history of fluid leakage in the inner ear.
2. A patient presents with symptoms of hearing loss and dizziness, and the healthcare provider diagnoses an oval window fistula. The provider performs a surgical repair to terminate the abnormal connection and prevent further fluid leakage.
3. During a routine examination, a healthcare provider discovers an oval window fistula in a patient. The provider recommends and performs a surgical repair to address the condition.
4. A patient with a known oval window fistula experiences recurrent ear infections. The healthcare provider decides to perform a surgical repair to prevent fluid leakage and reduce the risk of infections.
5. A healthcare provider performs a repair of an oval window fistula in a patient who has been experiencing balance issues and hearing disturbances.
6. After a thorough evaluation, a healthcare provider diagnoses an oval window fistula in a patient and recommends a surgical repair to address the condition and improve the patient’s symptoms.
7. A patient with a history of chronic ear infections undergoes a surgical repair of an oval window fistula to prevent further complications and improve their overall ear health.
8. A healthcare provider performs a repair of an oval window fistula in a patient who has been experiencing recurrent episodes of vertigo.
9. During a surgical procedure for another ear condition, a healthcare provider discovers an oval window fistula and decides to repair it to prevent future complications.
10. A patient with a known oval window fistula seeks medical attention due to persistent fluid leakage from the ear. The healthcare provider performs a surgical repair to address the issue.