# Canalplasty and Meatoplasty?



## tdesher (Jul 24, 2019)

I am coming up with different ways to code this, then I realized the mention of a stent being used at the end. Can someone help me figure what CPT codes to use and if I bill for the stent also? I am billing for an ASC. 

This is 15-year-old male with history of congenital appearing stenosis on the left external auditory canal was taken to the operating room, placed in the supine position.  After adequate endotracheal anesthesia was administered, he was prepped and draped for procedure of this type.  The external ear was viewed under the microscope with 250-mm focal length lens.  The canal would not admit a 4-mm speculum.  Utilizing a posterior canal, it was infiltrated with 1% Xylocaine with 1:100,000 epinephrine and the meatoplasty was carried out.  An incision was made in a V-type fashion through the skin and cartilage.  The cartilage was removed down to the bone.  At this point, the speculum could be advanced and the canal was viewed.  The skin of the canal was elevated laterally with the canal elevator and bony canal was noted to be extremely narrowed utilizing a curette.


There was a posterior inferior portion of the canal was curetted multiple times to open the canal.  At this point, a 4-mm speculum could be advanced to see the tympanic membrane which was within the normal limits.  At this point, a 4.5-mm speculum was placed in the canal and was opened.  Following this, the skin was elevated.  The posterior canal was laid over the area had been curetted.  A portion of AlloDerm was placed over the area of the meatoplasty.  A silastic stent was placed in the canal and utilizing iodoform gauze, the canal was packed tightly.  Cotton was placed and the procedure was terminated.  The patient was awakened and transferred to the recovery room in satisfactory condition.


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