Otolaryngology Coding Alert

Question: An otolaryngologist performed myringoplasty (69620) and harvested a graft. Can he use another CPT code for the work that he did for harvesting the ear graft, or is it inherent in the myringoplasty? Virginia Subscriber

Answer: Look at the graft's location. You should only bill for harvesting a graft from an ear other than the one receiving the graft. If the otolaryngologist harvests a graft from the right ear for placement on the right ear during a myringoplasty, include the graft in 69620 (Myringoplasty [surgery confined to drumhead and donor area]). But if the surgeon has to go to the other ear to obtain the graft, you should report 20926 (Tissue grafts, other [e.g., paratenon, fat dermis]) in addition to 69620. That's right, the claim should contain 69620 and 20926 without any multiple procedure modifiers. CPT designates 20926 as exempt from modifier 51 (Multiple procedures).

This status does not make 20926 an add-on code, but it exempts the graft from the multiple-procedure discount. Keep in mind: If your physician performs 69620 in the right ear, then you can apply modifier RT (Right side).