Wiki tympanomastoidectomy and cartilage graft

[daknaack]

I have found conflicting information in regards to billing out a graft during a tympanoplasty and mastoidectomy. According to the Oto Coding Alert, when the graft occurs as a second incision in the ear, it is not to be billed out separately, it would just be considered as part of the main procedure. According the the AAOHNS website, "the graft harvest through a separate incision and placement is additionally reportable".
I am curious as to what others do when billing this procedure out?
Thank you!

 

[nsteinhauser]

Is the surgeon using the cartilage graft to replace the natural ossicle? If that's the case, I don't code separately for it.
Anyone else have any thoughts?

 

[daknaack]

Yes, he is creating an ossciular cartilage graft.