Superior Semicircular Canal Dehiscense repair

What is the correct way to code these repairs is done with bone was? There are procedure codes for Oval Window repair and Round Window repair but nothing for SSCD. My provider does not like to bill unlisted codes but I can not find anything authoritative regarding this. Can anyone help?

re: Superior Semicircular Canal Dehiscense repair

I hate to keep asking, but I still am not able to find anything regarding this procedure. Any help would be greatly appreciated.

Thank you in advance!

re: Superior Semicircular Canal Dehiscense repair

Superior Semicircular Canal Dehiscence is a syndrome-SSCD
The Superior Semicircular Canal is in the inner ear and surgery
on this area can be performed by craniotomy or transmastoid.
I cannot give you the exact CPT® , this is not my area of expertise.
You should be able to ascertain the approach from the operative
report and if you have no report, you will need to ask the doctor.

Maybe someone else will be able to give you more information.

re: Superior Semicircular Canal Dehiscense repair

Technically there is no CPT® code for this procedure so you'd have to use an unlisted code. Some folks use 61304 (Exploratory craniotomy).

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com

re: Superior Semicircular Canal Dehiscense repair

My doctor does not like the unlisted code. I HAVE come across 61304 before but wasn't sure if that would definitely be correct. Sometimes he performs these procedures as co surgeon with a neurologist who is repairing an encephalocele at the same time and most of the time in the same area of the dehiscense and they are billing a craniotomy approach with definitive skull base tumor removal procedure as well as 62140 for skull base repair. My gut is telling me that this is just not correct.

re: Superior Semicircular Canal Dehiscense repair

Trust your gut.