Otolaryngology Coding Alert

Question: Our patient had a tonsillectomy with a 90-day global period on Oct. 12, 2009, and then we performed a Baha cochlear implant for her on Dec. 29, 2009. How do we code for a Baha implant, and should we report it with modifier 78 or 79, or both?

Minnesota Subscriber

Answer: When reporting the Baha implantation, you would need to know whether the procedure involved a mastoidectomy and then choose from one of the following codes:

• 69714 -- Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy

• 69715 -- Implantation, osseointegrated implant,...with mastoidectomy.

If the procedure requires a longer abutment, you could report it with the appropriate unlisted procedure code:

• 69399 -- Unlisted procedure, external ear.

When you use an unlisted procedure code such as this one, you must submit a special report to the payer that details the procedure.

You would append modifier 79 (Unrelated procedure or  service by the same physician during the postoperative period) to the appropriate Baha implant code to show that it is unrelated to the tonsil surgery (42820-42826, depending on the patient's age and the nature of the procedure).