Summary & Overview
CPT 0952T: Revision or Replacement of Implantable Active Middle Ear Hearing Device
CPT code 0952T represents surgical revision or replacement of a totally implantable active middle ear hearing implant (AMEI), a specialized otologic procedure that includes mastoidectomy and replacement of the sound processor. This code matters nationally because it captures care for patients with implantable middle ear devices who require corrective surgery, an area with unique clinical complexity and resource needs.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the procedure, expected sites of service, common modifiers, and relevant clinical context. The publication summarizes typical billing considerations, outlines where this service is performed (hospital operating room or ambulatory surgery center), and explains why accurate coding is important for claims processing and policy alignment.
The material provides benchmarks and payer coverage patterns where available, highlights clinical implications of device revision or replacement, and notes data availability limitations. The goal is to give billing managers, coding professionals, and policy analysts a clear, national-level briefing on CPT code 0952T, its clinical purpose, and the topics to consider when managing claims and coverage for AMEI revision or replacement.
Billing Code Overview
CPT code 0952T describes a surgical procedure to revise or replace a totally implantable active middle ear hearing implant (AMEI). The procedure includes performing a mastoidectomy and replacing the sound processor as part of the revision or replacement surgery.
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Service type: Surgical revision or replacement of an implantable active middle ear hearing device
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a previously implanted totally implantable active middle ear implant (AMEI) who presents with progressive device malfunction, recurrent otorrhea, persistent conductive or mixed hearing loss despite device use, or pain suggesting extrusion or infection. The patient often has a history of prior mastoid or middle ear surgery and returns to the otolaryngology clinic after device alerting or audiologic testing shows loss of aided benefit. The surgical workflow includes preoperative audiologic assessment and imaging (CT temporal bones) to evaluate implant and mastoid anatomy, perioperative anesthesia and antibiotics, surgical explantation of the malfunctioning AMEI component(s) as indicated, mastoidectomy to access and revise implant hardware, replacement or revision of the subcutaneous/transcutaneous sound processor or internal transducer, intraoperative verification of device positioning, and postoperative audiology programming and wound care. Typical perioperative documentation includes device serial numbers, intraoperative findings, reason for revision (mechanical failure, infection, extrusion, migration), components revised or replaced, estimated blood loss, and any complications. Usual site of service is an operating room in an ambulatory surgery center or hospital outpatient setting, with postoperative follow-up in clinic and audiology for device reprogramming.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than usual (extensive scar removal, complex revision beyond standard scope). |