Otolaryngology Coding Alert

Question: Is there a code for microscopic debridement and cautery of scar tissue of the tympanic membrane?

Arizona Subscriber

 
Answer: If the procedure was performed through the external ear canal opening, use 69450 (Tympanolysis, transcanal). Coders Desk Reference notes that this procedure involves removing adhesions, lesions or other irritations (such as scar tissue) to the tympanic membrane or eardrum.
 
This procedure is typically performed for granulation (excess inflammatory tissue) in patients with fungal otitis externa, for example.
 
In this case, the problem is scarring, which may be the result of trauma (including severe acoustic trauma) to the tympanic membrane. As the scar tissue fills the wound, the individuals ability to detect low-decibel sounds may be impaired. The use of the operating microscope is included in the code and should not be billed separately.