How To Use CPT Code 69930

CPT 69930 describes the surgical procedure for cochlear device implantation, with or without mastoidectomy. 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 69930?

CPT 69930 can be used to describe the surgical procedure for cochlear device implantation, with or without mastoidectomy. This code is used when a provider surgically places an implant under the skin behind the ear, which includes an external microphone, speech processor, and transmitter, as well as internal parts such as a receiver, stimulator, and an array of electrodes wound through the cochlea. The procedure destroys any residual hearing in the implanted ear, which is why single ear implantation is more commonly done.

2. Official Description

The official description of CPT code 69930 is: ‘Cochlear device implantation, with or without mastoidectomy.’

3. Procedure

1. The patient is placed in the supine position.
2. The area directly behind the ear is shaved and cleaned.
3. A C-shaped postauricular incision with a posterosuperior extension is made.
4. A musculoperiosteal Palva flap composed of temporalis fascia, muscle, and periosteum is created.
5. A well for the implant is drilled, and a cochleostomy is performed.
6. The device is implanted and placed in the well.
7. The electrode array is inserted into the scala tympani of the basal turn of the cochlea.
8. The flap is closed, completely covering the electrode and hub.
9. A standard dressing is applied.

4. Qualifying circumstances

CPT 69930 is performed on patients who require cochlear device implantation, with or without mastoidectomy. This procedure is typically done on patients with severe hearing loss or deafness. The surgery is performed by a qualified healthcare provider who specializes in otolaryngology or otology.

5. When to use CPT code 69930

CPT code 69930 should be used when a provider performs cochlear device implantation, with or without mastoidectomy. This code is appropriate for reporting the surgical procedure for patients who require a cochlear implant to restore or improve their hearing.

6. Documentation requirements

To support a claim for CPT 69930, the healthcare provider must document the following information:

• Patient’s medical history and diagnosis of severe hearing loss or deafness
• Description of the surgical procedure performed, including whether mastoidectomy was included
• Date of the surgery
• Details of the implant used, including the manufacturer and model
• Any complications or additional procedures performed during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the healthcare provider performing the surgery

7. Billing guidelines

When billing for CPT 69930, ensure that the procedure was performed by a qualified healthcare provider and that the documentation supports the medical necessity of the surgery. It is important to follow the payer’s guidelines for reporting bilateral procedures, using modifiers such as 50 for bilateral surgery or LT and RT for left and right sides. Medicare’s bilateral surgery rules may apply, with the first surgery reimbursed at 100% and the second-side surgery reimbursed at 50%.

8. Historical information

CPT 69930 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 qualified otolaryngologist performing cochlear device implantation, with mastoidectomy, on a patient with severe hearing loss.
2. A healthcare provider specializing in otology performing cochlear device implantation, without mastoidectomy, on a patient who is deaf.
3. A surgeon performing cochlear device implantation, with mastoidectomy, on a patient with congenital hearing loss.
4. An otolaryngologist performing cochlear device implantation, without mastoidectomy, on a patient with acquired hearing loss due to trauma.
5. A healthcare provider specializing in otology performing cochlear device implantation, with mastoidectomy, on a patient with progressive hearing loss.
6. A qualified otolaryngologist performing cochlear device implantation, without mastoidectomy, on a patient with age-related hearing loss.
7. A surgeon performing cochlear device implantation, with mastoidectomy, on a patient with hearing loss caused by a genetic condition.
8. An otolaryngologist performing cochlear device implantation, without mastoidectomy, on a patient with hearing loss due to ototoxic medication.
9. A healthcare provider specializing in otology performing cochlear device implantation, with mastoidectomy, on a patient with hearing loss caused by a viral infection.
10. A qualified otolaryngologist performing cochlear device implantation, without mastoidectomy, on a patient with hearing loss of unknown etiology.