cochlear implant surgery

[lisa@oh-hears.com]

Hi all! I am new to AAPC. I am working on my cpc and cbp right now. I am working for physiciain that has just started her own practice. I have learned a lot in the last 6 months about credentialing, contracting, revenue cycle and am anxious to learn more to get our fledgling practice moving in the right direction. One place that I could use some help in is surgery billing for cochlear implantation. I need some guidance on what a complete surgical claim should include in regard to cpt codes. We are currently using the 69930 for the surgery along with L8614 for the device. Most of the our implant surgeries are done in an ASC. Are there additional codes that I should be using in conjuntion with these codes? The codes that my physician would like to use are...
69930
69502
20922
69440
69990

I am fairly certain that the ones highlighted in red are bundled with the 69930. Additionally, what should the modifiers be aside from laterality LT and RT?
Any feedback would be greatly appreciated.

 

[NRaizman]

69930 includes mastoidectomy, and middle ear exploration would not be reimbursable as it is part of the approach.
Why is there a code for a fascia lata graft? That would need to be justified and we'd need to see an operative report.
69990 is a little unclear, as 69930 is not within the list of codes in the CPT descriptor that are restricted from using it, but the RUC data clearly notes that the operating microscope is integral to the case, and the value of the scope is included in the RUC's valuation, so I would consider 69990 bundled.

N

 

[lisa@oh-hears.com]

Hi N!
I appreciate you taking time to reply to me. I am uploading a copy of the op note. Any feedback you can provide would be greatly appreciated.

 

[NRaizman]

I would consider coding the graft as 15769. The code mentioned above is strictly for a fascia lata graft from the thigh.
Otherwise 69930.
N.