Otolaryngology Coding Alert

Question: The operative report describes a procedure under general anesthesia as “examination of right ear under anesthesia with removal of tympanic membrane granuloma and cautery.” The inner aspect of the eardrum was intact. The surgeon used the binocular microscope to visualize the ear canal and clear it of cerumen, examine and remove the granuloma. The patient was taken to surgery with the possibility of having a myringoplasty. What are the correct codes for this procedure?

Washington Subscriber

Answer: The correct choices are 92502 (Otolaryngologic examination under general anesthesia) and 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions). The removal of the impacted ceruman, 69210, cannot be billed with 92502 because it is bundled with 92502.

Myringoplasty is a procedure to close a hole or other perforation in the eardrum. Because the inner aspect of the patient’s eardrum was intact, your surgeon removed the granuloma and cauterized the site, but didn’t need to repair any perforations. Therefore, the code for benign lesion destruction (17110) is more accurate than 69620 (Myringoplasty [surgery confined to drumhead and donor area]).