2025 CPT code 69633
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Auditory System Feed
Tympanoplasty without mastoidectomy, including canalplasty, atticotomy and/or middle ear surgery, initial or revision; with ossicular chain reconstruction and synthetic prosthesis.
Modifiers may be applicable to indicate laterality (LT, RT), increased procedural services (22), bilateral procedures (50), multiple procedures (51), among others.
Medical necessity is established by documentation of chronic ear disease, eardrum perforation, conductive hearing loss, and failure of conservative treatment.Preoperative audiometry demonstrating conductive hearing loss is typically required.
The surgeon performs the procedure under anesthesia. They make an incision, access the middle ear, clean the area, inspect the ossicles, and reconstruct the ossicular chain using a synthetic prosthesis (PORP or TORP). A cartilage graft and packing material may be used. The eardrum is repaired with a graft, and the ear canal is packed. Any external incisions are sutured and dressed.
In simple words: This surgery repairs a hole in the eardrum and rebuilds the tiny bones in the middle ear to improve hearing.An artificial part is used to rebuild these bones.The surgery might also involve fixing the ear canal and other parts of the middle ear, but not the mastoid bone behind the ear.
This procedure involves reconstructing the tympanic membrane (eardrum) to repair a perforation and reconstructing the ossicular chain (small bones in the middle ear) to improve conductive hearing.A synthetic prosthesis is used for the ossicular chain reconstruction. The procedure may also include reconstruction of the ear canal, an incision into the tympanic attic (upper portion of the middle ear), and other middle ear surgeries.It does not include removal of the mastoid cavity.The procedure is performed through a postauricular (behind the ear) or transcanal (through the ear canal) approach. The surgeon removes any adhesions, debris, and/or cholesteatoma from the middle ear, then reconstructs the ossicular chain using a synthetic prosthesis (PORP or TORP, depending on the stapes superstructure). A cartilage graft may be placed, and packing is used to support the reconstruction. The eardrum is repaired with a fascial graft or other tissue, and the ear canal is packed.This code can be used for both initial and revision procedures.
Example 1: A patient with a perforated eardrum and conductive hearing loss due to prior infection undergoes tympanoplasty with ossicular chain reconstruction using a PORP., A patient with a recurrent perforation and disrupted ossicular chain after a previous tympanoplasty undergoes revision tympanoplasty with TORP placement., A child with a cholesteatoma and ossicular damage undergoes tympanoplasty with atticotomy, removal of the cholesteatoma, and ossicular chain reconstruction using a PORP.
Documentation should include the diagnosis, operative report detailing the procedure performed (including type of prosthesis used, any additional procedures like canalplasty or atticotomy), pre- and postoperative hearing assessments, and any complications.
- Specialties:Otolaryngology
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient, Office