Wiki reconstruction of external ear after being bitten off by dog

[tedebears30]

Hi
We have a 10 yr old boy who had his ear basically bitten off. He was seen by a doctor who placed a permanent suture and sutured his ear to the skin on his head to allow healing of the ear injury. He was told to come back in 6 months to a year to remove the suture and do a reconstruction. The original doctor retired and now my doctor is seeing him.

My doctor states he would need to relieve the suture and then modify/reconstruct the ear without using any flaps or grafts. He would most likely be able to close any gaps with just sutures.

I know i need to get authorization from the insurance, that is why we don't want to use an unlisted code. I don't think this qualifies as complex repair because it is not an open wound.

My question is this- what code do i need to use without using an unlisted code? Would it be 69300 otoplasty? Any help would be greatly appreciated.

 

[b.cobuzzi]

It was an open wound originally and this is the second stage to the repair. I would use the repair codes that apply and not worry that it is not currently an open wound.

I do not think it is an Otoplasty (69300) as below are the lay description and clinical responsibility to an Otoplasty:

Lay Description
The provider rectifies acquired or congenital deformities of ear, e.g., protruding ear; to do so, he reshapes structural ear elements to achieve a more desirable cosmetic appearance.
Clinical Responsibility
When the patient is appropriately prepped and anesthetized, the provider makes an incision behind the ear at its attachment to the head. The size of the ear and the amount of deformity determines which techniques the provider uses to reshape or reposition the ear. The provider removes cartilage and skin to achieve the desired effect if the ear is too large. He may trim cartilage to obtain a more natural shape to the ear or pin it back to skin on the head to reduce protrusion. In some situations, the provider may not remove cartilage but simply place sutures to through cartilage and skin to reshape the ear and secure it in place. Finally, the provider controls any bleeding, closes any rema