2025 CPT code 69632

Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (e.g., postfenestration).

The CPT code 69632 includes canalplasty, atticotomy, and/or middle ear surgery. These procedures should not be reported separately when performed as part of the tympanoplasty. Modifier -51 should be appended to indicate multiple procedures when other procedures, such as stapes mobilization, are performed.

Modifiers may be applicable. Modifier 51 is used for multiple procedures.Modifiers 22, 52, 53, 73, 74, 76, 77, 78, and 79 could potentially be applicable in specific scenarios involving increased services, reduced services, discontinued procedures, repeat procedures, or unplanned return to the operating room.

Medical necessity for this procedure is established by documentation of conductive hearing loss due to eardrum perforation or ossicular chain disruption. The documentation should clearly link the hearing loss to the anatomical defect and explain how the surgical repair will improve the patient's hearing.Prior authorization may be required by some payers.

The physician is responsible for preparing and anesthetizing the patient, performing the surgical repair of the tympanic membrane and ossicular chain, and providing post-operative care.

IMPORTANT For the same procedure without ossicular chain reconstruction, use 69631.For other eardrum repair procedures, see 69633-69646 and 69610 or 69620.

In simple words: This surgery fixes a hole in your eardrum and rebuilds the tiny bones in your middle ear to help you hear better. The surgeon goes into your ear, cleans out any problems, and then fixes the eardrum and the small bones.Sometimes, they might use donor bone or cartilage to rebuild the bones. This helps the sound travel better into your inner ear.

This procedure involves reconstructing the tympanic membrane (eardrum) to repair a perforation and reconstructing the ossicular chain to improve conductive hearing.It may include reconstruction of the ear canal, an incision into the tympanic attic, and other middle ear surgeries, but does not include mastoidectomy.The surgeon accesses the middle ear, removes any adhesions, debris, or cholesteatoma. The ossicular chain is then inspected, sculpted, and repositioned.Donor ossicles, sculpted bone, or cartilage may be used for ossicular chain reconstruction.A graft is used to repair the eardrum perforation.Packing is placed in the middle ear and ear canal as needed.Finally, any incisions are sutured and dressed.

Example 1: A patient presents with a perforated eardrum and conductive hearing loss due to a previous ear infection. The physician performs a tympanoplasty with ossicular chain reconstruction using a sculpted bone graft., A patient with a history of cholesteatoma undergoes a tympanoplasty to remove the cholesteatoma and repair the damaged eardrum and ossicles. A synthetic prosthesis is used for ossicular chain reconstruction., A patient with a traumatic eardrum perforation and disruption of the ossicular chain undergoes a tympanoplasty to repair the eardrum and reconstruct the ossicular chain using a donor ossicle.

Documentation should include the operative report detailing the surgical technique, the type of ossicular chain reconstruction performed (e.g., type of graft or prosthesis used), and any complications encountered.Pre-operative audiograms demonstrating conductive hearing loss and evidence of eardrum perforation should also be included.Post-operative care instructions and follow-up plans should also be documented.

  • Revenue Code: P5E - AMBULATORY PROCEDURES - OTHER
  • Specialties:Otolaryngology
  • Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient
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