Otolaryngology Coding Alert

Question: Two weeks after undergoing tympanoplasty with mastoidectomy (69641), a patient returns to the office and the otolaryngologist performs debridement of the mastoidectomy cavity. Can I bill for the postoperative cleaning using 69220?

New York Subscriber

Answer: Since the debridement is related to the initial procedure, you will want to take a look at the specific surgical code’s global period to determine whether or not 69220 (Debridement, mastoidectomy cavity, simple (eg, routine cleaning)) is billable. You’ll find that CPT^® code 69641 (Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction) has a global period of 90 days. Because the debridement is within the surgical code’s global period, you will not report 69220 separately.

Hypothetical: If the patient returns within the global period to have an unrelated procedure on the same ear as the prior tympanoplasty and mastoidectomy, you’ll want to submit the procedure code with modifier 79 (Unrelated procedure or service by the same physician … during the postoperative period).