2025 CPT code 69100
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Auditory System Surgery Feed
Biopsy of the external ear (earlobe or helix).
Modifiers such as 51 (multiple procedures), 22 (increased procedural services), and others may be applicable depending on the specific circumstances of the procedure.Refer to the current CPT manual and payer guidelines for appropriate modifier use.
Medical necessity is established when a lesion on the external ear shows characteristics suggestive of malignancy (e.g., rapid growth, change in color or size, bleeding, ulceration) or when the lesion is aesthetically concerning or interferes with normal function.The biopsy is necessary to rule out malignancy or to determine the nature of a concerning growth.
The physician is responsible for pre-operative assessment and preparation of the patient, performing the surgical biopsy, providing post-operative care, and sending the tissue sample to the pathology lab for analysis. They must also interpret the pathology results and discuss them with the patient.
In simple words: The doctor removes a small piece of abnormal tissue from the outer ear to test it for cancer. They numb the area first, then take the sample and send it to a lab for testing.
Surgical removal of a portion of abnormal tissue from the external ear (earlobe or helix) for pathological examination to determine whether the lesion is benign or malignant.The procedure involves prepping and anesthetizing the area (typically with local anesthetic), then using various techniques (e.g., needle biopsy, punch biopsy, or shave biopsy) to remove a tissue sample.The sample is sent to a laboratory for analysis. Post-procedure care includes applying antibiotic ointment and dressing the site. Sutures are typically not required.
Example 1: A patient presents with a suspicious mole on their earlobe. The physician performs a shave biopsy of the lesion under local anesthesia. The tissue is sent to pathology, which reveals benign nevus., A patient has a rapidly growing lesion on their helix.The physician performs an excisional biopsy under local anesthesia. The pathology report indicates squamous cell carcinoma, necessitating further surgical intervention., A patient has multiple small lesions on their earlobe. The physician performs multiple punch biopsies under local anesthesia using modifier 51. Pathology reveals multiple benign seborrheic keratoses.
* Detailed history and physical examination noting the location, size, and characteristics of the lesion.* Pre-operative and post-operative photographs documenting the lesion and the surgical site.* Pathology report detailing the nature of the removed tissue.* Documentation of the anesthesia used.* Notes on any complications or adverse events during or after the procedure.* Appropriate informed consent documentation.
** The provided descriptions refer to biopsies of the external ear, including the earlobe and helix. Biopsies of the external auditory canal are coded separately (CPT 69105).The choice of biopsy technique depends on the size, depth, and location of the lesion.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: This information is not provided in the source data and requires access to current Relative Value Units (RVUs) databases.Consult your payer's specific fee schedule.
- Global Days: The global surgical period for this procedure is not specified in the provided data.It likely varies depending on the complexity of the biopsy and the payer's guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code as it represents a complete procedure.
- Fee Schedule: Historical fee schedule data is not available in the provided source. Refer to historical CPT fee schedule databases for relevant information.
- Specialties:Otolaryngology, Dermatology, Plastic Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center