2025 CPT code 69720
Effective Date: N/A Surgery - Surgical Procedures on the Auditory System Feed
Decompression of facial nerve, intratemporal, lateral to the geniculate ganglion.
Modifiers may be applicable depending on the circumstances of the procedure.Refer to current CPT modifier guidelines for appropriate usage.
Medical necessity for 69720 must be established by demonstrating the presence of facial nerve compression lateral to the geniculate ganglion causing significant functional impairment, such as facial paralysis or weakness. The documentation must support that the surgical decompression is necessary to alleviate the compression and restore function.
The physician is responsible for performing the surgical decompression of the facial nerve.This involves precise dissection and manipulation within the temporal bone, requiring specialized knowledge of the anatomy of the head and neck, as well as microsurgical skills.
In simple words: This surgery relieves pressure on the facial nerve inside the skull to restore facial movement. The surgeon makes an incision near the ear, lifts the skin, and carefully opens the skull bone to access the nerve. The outer covering of the nerve is then opened to relieve pressure, and the incision is closed.
This procedure involves decompressing the facial nerve within the temporal bone, specifically the segment lateral to the geniculate ganglion.The surgeon accesses the nerve through an incision, typically behind or above the ear. After elevating a skin flap and exposing the temporal muscle, the surgeon drills over the mastoid bone until the otic capsule is identified.The facial nerve sheath is then carefully slit using a microscalpel to relieve pressure.A piece of bone from the surgical site may be used to cover any defects in the tympanic membrane before closing the incision.
Example 1: A patient presents with Bell's palsy, and imaging reveals compression of the facial nerve lateral to the geniculate ganglion. Code 69720 is used for the surgical decompression., A patient experiences facial paralysis following a temporal bone fracture. Imaging shows impingement of the facial nerve lateral to the geniculate ganglion, requiring decompression (69720)., A tumor is found to be compressing the facial nerve lateral to the geniculate ganglion.Code 69720 is used for the decompression procedure performed alongside tumor removal.
Documentation should include details of the patient's symptoms, diagnostic imaging results confirming nerve compression, operative report detailing the surgical approach and findings, and post-operative assessment of facial nerve function.
** For decompression medial to the geniculate ganglion, use code 69725. For total facial nerve decompression and/or repair, consider code 69955.For specific approaches to the posterior cranial fossa involving facial nerve decompression, refer to codes 61595-61598.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- Global Days: 90
- Specialties:Otolaryngology, Neurosurgery, Plastic Surgery
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital