2025 CPT code 69930
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Auditory System Surgery Feed
Cochlear device implantation, with or without mastoidectomy.
Modifiers 50 (bilateral procedure), LT (left side), RT (right side) may be applicable depending on the specific circumstances and payer requirements. Additional modifiers may be used as clinically appropriate (refer to CPT guidelines).
Medical necessity is established through comprehensive audiological testing demonstrating profound sensorineural hearing loss, lack of benefit from hearing aids, and the patient's ability and willingness to participate in auditory rehabilitation.
The surgeon is responsible for the surgical implantation of the cochlear device.This includes making incisions, creating a well for the implant, performing a cochleostomy, implanting the device, inserting the electrode array, and closing the incision. Post-operative care is included in the global period.Audiology services (programming and adjustments of the device) are the responsibility of the audiologist and are billed separately.
In simple words: A cochlear implant is surgically placed behind the ear. It has external parts (microphone, processor, transmitter) and internal parts (receiver, stimulator, electrodes in the cochlea). The electrodes send signals to the brain, helping to restore hearing.This surgery may involve removing some bone (mastoidectomy) and usually results in the loss of any remaining hearing in that ear.
This procedure involves the surgical implantation of a cochlear device, which may or may not include a mastoidectomy.The external components include a microphone, speech processor, and transmitter. The internal components consist of a receiver, stimulator secured in the bone, and an electrode array inserted into the cochlea's scala tympani.This sends impulses to the auditory nerve, ultimately reaching the brain. The procedure results in the loss of any residual hearing in the implanted ear.
Example 1: A 5-year-old child with profound bilateral sensorineural hearing loss undergoes bilateral cochlear implantation.The procedure includes mastoidectomies on both sides., A 30-year-old adult with unilateral profound sensorineural hearing loss and no benefit from hearing aids receives a single cochlear implant. No mastoidectomy is performed., A 70-year-old patient with unilateral sensorineural hearing loss and significant residual hearing chooses to proceed with a cochlear implant despite the potential loss of remaining hearing.No mastoidectomy is performed.
Preoperative assessment including audiological evaluations, imaging studies (if necessary), informed consent, operative report detailing surgical steps and device specifics, postoperative recovery notes, and audiological programming records.
** Initial programming and subsequent adjustments of the cochlear implant by an audiologist are billed separately using codes 92601-92604 based on the patient's age.Check with the payer to determine their preference for billing bilateral procedures (single line with modifier 50 or two lines with LT/RT modifiers). Medicare pays 100% for the first side and 50% for the second side in bilateral procedures. Always verify payment on the Explanation of Benefits (EOB).
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in provided text. Refer to CMS guidelines and payer-specific fee schedules for RVU values.
- Global Days: The global period for this procedure is 90 days.Post-operative care and programming of the speech-generating device are included within this period.Additional audiology services (programming, adjustments) are billed separately.
- Payment Status: Active
- Modifier TC rule: Information not available in provided text.Refer to CPT guidelines.
- Fee Schedule: Information not available in provided text. Refer to historical CPT fee schedules and payer-specific data.
- Specialties:Otolaryngology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital