CPT^® 21086, Under Prosthesis-Impression and Custom Preparation

The Current Procedural Terminology (CPT^®) code 21086 as maintained by American Medical Association, is a medical procedural code under the range - Prosthesis-Impression and Custom Preparation.

Additional/Related Information

Tabs

Summary

The provider fabricates an auricular prosthesis by taking an impression, or negative imprint, of the patient's ear. An auricular prosthesis replaces an ear that is partially or totally missing due to surgery, trauma, or a congenital defect.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 21086 ? Start a discussion here

Surgical obturator prosthesis

After surgical obturator prosthesis 21076 is charged and the patient's global period is over, how do you code for adjustments? Miscellaneous code 21086 with report?... [ Read More ]

ENT Fitting Question

I understand 21086 but my physicians believe that 21086 is appropriate for what they are documenting below and have received confirmation from an ENT source- that I don't know where it came from becau... [ Read More ]

ENT Fitting Question

CPT states 21086 should be used when the provider designs and prepares the prosthesis. Maybe V5275?... [ Read More ]

ENT Fitting Question

oh there were two made, one for each ear and it was billed out as 21086-50 :)... [ Read More ]

ENT Fitting Question

We are having a little debate on billing out 21086 for ear well devices... does anyone have any information on this? Does this look like 21086 even if the physician doesn't say he did a mold/cast? So ... [ Read More ]

EarWell System (use 21086??)

Unless your physician actually designs and prepares a prosthesis (ie, not prepared by an outside lab), you cannot bill 21086; also, I do not believe this item can be referred to as a "prosthesis" as i... [ Read More ]

EarWell System (use 21086??)

I have a sales rep with a product (called EarWell) advising me to use 21086. I don't get a warm fuzzy feeling using this code because of the wording in the CPT book, "...physician actually designs and... [ Read More ]

View All