Otolaryngology Coding Alert

Question: Can we bill separately for graft harvesting when a tympanoplasty is performed? What codes should be used?

Alabama Subscriber

Answer: The site of the graft is needed to answer this question. If the graft comes from the ear that requires tympanoplasty, harvesting should not be billed separately. If the graft is obtained from the other ear, several codes may apply and harvesting may be reported separately. In such cases, the most likely code would be 15770 (graft; composite [e.g., full thickness of external ear or nasal ala], including primary closure, donor area; derma-fat-fascia). If the claim is denied (because carriers are accustomed to seeing claims where the graft was obtained from the same site), an appeal should be filed and the fact that the graft was obtained elsewhere should be documented in the patient's medical record.
 
The otolaryngologist should help determine the correct graft code for these procedures, because only he or she knows the details.