Otolaryngology Coding Alert

Question: An otolaryngologist gave a transtympanic injection of a steroid for sudden hearing loss. The physician made no incision in the eardrum. How should I code this?

New Jersey Subscriber

Answer: You should code a transtympanic (TM) injection of drugs, such as steroids, with 69801 (Labyrinthotomy, with or without cryosurgery including other nonexcisional destructive procedures or perfusion of vestibuloactive drugs [single or multiple perfusions]; transcanal). Code 69801 applies to perfusion treatment of the inner ear.

Don't overlook billing some related items in addition to 69801. For instance, you may also report any balance or hearing testing as indicated. Also, use the J code for the drugs, such as:

- Decadron with J1100 (Injection, dexamethasone sodium phosphate, 1 mg)

- Depo-medrol using J1020, J1030 or J1040 (various dosages of Injection, methylprednisolone acetate)

- gentamicin with J1580 (Injection, garamycin, gentamicin, up to 80 mg).

Caution: Because 69801 has 90 global days, you should include subsequent injections that the ENT administers within the global period in 69801's initial coding.

Payment protector: Before providing this service, check that the patient's policy covers 69801 with a diagnosis of sudden hearing loss (388.2, Sudden hearing loss, unspecified). If the insurer restricts the TM injection to Meniere's disease (386.00-386.04), obtain an advance beneficiary notice for a Medicare beneficiary or use the equivalent insurer patient financial responsibility statement for a private-pay patient.