Summary & Overview
CPT 69110: Excision of External Ear Lesion, Specimen for Pathology
Headline: CPT code 69110: Excision of External Ear Lesion, Specimen Sent for Pathology
Lead: CPT code 69110 documents surgical removal of part of the external ear (for example, earlobe or helix) when a lesion is present, with the excised tissue submitted for laboratory diagnosis. This code captures a common minor surgical procedure used to establish histologic diagnosis and guide subsequent care.
CPT code 69110 matters nationally because it documents both a surgical intervention and a diagnostic step—removal of tissue with submission for pathology—which affects clinical decision-making, resource use, and payment across outpatient settings. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for use of CPT code 69110, typical sites of service, and payer coverage considerations. The publication provides benchmarks for utilization and reimbursement where available, summarizes relevant policy updates affecting outpatient minor surgical procedures and specimen submission, and outlines coding and billing considerations that influence claim adjudication. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 69110 describes an excision of a portion of the external ear (such as the earlobe or helix) that contains a lesion, with the specimen sent to the laboratory for diagnostic evaluation to determine malignant or benign pathology.
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Service type: Surgical excision of external ear lesion
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Typical site of service: Outpatient clinic, ambulatory surgical center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents to an outpatient dermatology clinic with a 6-mm crusted, changing lesion on the helix of the right ear that has bled intermittently. On exam the lesion is suspicious for basal cell carcinoma. The dermatologist schedules a minor outpatient surgical procedure to excise the lesion with narrow margins under local anesthesia. The specimen is placed in formalin and sent to the pathology laboratory for histologic diagnosis to determine benign versus malignant disease. Typical workflow: pre-procedure consent and history, local anesthetic infiltration, surgical excision of the external ear lesion, hemostasis and simple closure, specimen labeling and submission to pathology, post-procedure wound care instructions, and documentation of size of specimen, margins, and diagnosis code for billing and medical record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When excisions are performed on both ears during the same operative session |
51 | Multiple procedures | When other distinct procedures are performed on the same day in addition to the excision |