Otolaryngology Coding Alert

Question: How would you code an excision of an infected preauricular cyst or sinus? Code 69700 (closure postauricular fistula, mastoid [separate procedure]) is only for a postauricular.

Anonymous Utah Subscriber

Answer: The preauricular area is on the side of the head just in front of the ear. When coding preauricular cyst or sinus removal, 69700 does not apply; nor does 69020 (drainage external auditory canal, abscess).

Instead, coders should look for excision and closure codes in CPT 2000s integumentary section. For a preauricular cyst, 1144x (excision, other benign lesion [unless listed elsewhere], face, ears, eyelids, nose, lips, mucous membrane) should be billed (the exact code would be determined by the size of the excision), along with a layered closure (1205x, layer closure of wounds of face, ears, eyelids, nose, lips and/or mucous membranes). Again, the specific code would depend on the size of the wound.