# Coding challenge - Help



## ldunder

Hi!  I work for an ENT specialist center and from time to time I come across a coding challenge that I'm still not satisfied with the end results.  If you were the coder how would you code the following surgical procedures that took place on the right side only?

80% auriculectomy
radical neck dissection
parotidectomy w/ sacrifice of the facial nerve
pectoral skin fasical flap to the temporal bone
partial mandibulectomy
ligation of the external branches of the carotid artery
resection of all of the cartilaginous bony car canal
complex facial closure 9 x 9 cm.

And help will be greatly appreciated.


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## jackjones62

I am usually pretty good at this, but considering I am going in blind w/o an operative report, here it goes:

CPT 69155 - Radical excision external auditory canal lesion with neck dissection; this code encompasses the resection of ear canal, neck dissection, parotidectomy w/facial nerve sacrifice as well as the partial mandibulectomy.

CPT 69120 - Excision external ear; complete amputation; you mentioned 80% but really, what is left????

CPT 37600 - Ligation; external carotid artery.

CPT 15732 - Muscle, myocutaneous, or fasciocutaneous flap; head and neck.

Was any temporal bone was taken? and I would not charge for the complex closure as that is inherent to the flap.

Jennifer
CT ENT


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## ldunder

Thanks so much for your response!  The CPT 69155 was the code I wanted cleared up in my mind and you did a fine job in clarifying this code.  I had used several resources to research this code but received conflicting information which encouraged me to turn to the AAPC forum for further guidance.  Concerning the removable of the outer ear, only the superior aspect of the ear was left so the patient could continue to wear glasses.  Normally the temporal bone is removed but during this particular surgical case it was not.  Again, thank you for your help.


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