Question Clarification on 69145

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Monsheri

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I have been coding ENT for a while - and my understand of of anatomy of the outer ear is that it is made up of skin and cartilage, and 69145 is a specified code for the ear canal itself when removing soft tissue lesion due to the added complexity of having to remove it from the ear canal and not the outer ear (pinna) (microscope normally used). By definition skin and cartilage are both soft tissues.
What would you code for the above op note? 69145 or 11440?
 
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Thanks for the response - and honestly I would agree with both of you but this was a case that the doctor wanted to bill the skin code and not the 69145, which I did not think was correct. This eventually got sent to 3M for clarification due to the back and forth on the Dx being just a mole. - after much back and forth on clarifying again with 3M - they state that to bill the 69145 the lesion must be below the skin.
I personally do not think 69145 is dx driven but I don't get to chose and have to follow the path that 3M experts have laid out. I am glad that I am not alone in my thinking though and that you both would have agreed with me.
If any of you have questions on what they said in response, I can come back and post it. (I do have to add an edit from my original post - the the ear canal is only made up of skin and cartilage - the remaining outer ear has a very thin layer of SubQ that is pretty attached to the cartilage itself- and if this argument was for this part of the ear I would have agreed with the skin code but it was inside the ear canal and that was my problem)
 
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