Neurosurgery Coding Alert

Question: How would I code for implantation of an osseointegrated implant? Is the replacement or removal of the implant separately reportable, or is it part of the osseointegrated implant code?

Ohio Subscriber

Answer: You can code osseointegrated implants, replacements, and removals separately.

For the osseointegrated implant, you’d choose from the following codes, depending on encounter specifics:

(Note: There were changes to this code set in 2023. A * marking indicates a new code, while a # marking indicates a resequenced code.)

• #69714(Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor)
• #69716 (… with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex)
• *#69729 (… with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex)

Replacement/removal codes: When the patient returns for replacement/removal of the osseointegrated implant, you’d choose from the following codes, depending on encounter specifics:

• #69719 (Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex)
• *#69730 (… with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex)
• #69727 (Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex)
• *# 69728 (…with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex).