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CPT 69631: Tympanic Membrane Reconstruction for Perforation
CPT code 69631 denotes surgical reconstruction of the tympanic membrane (eardrum) to repair perforations, often with reconstruction of the ear canal or tympanic attic exposure but excluding mastoidectomy and ossicular chain reconstruction. This procedure is an important component of otologic surgical care aimed at restoring hearing, preventing recurrent infections, and preserving middle ear function. Nationally, it is relevant to specialists in otolaryngology and to payers managing surgical and outpatient procedural benefits.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing perspective on CPT code 69631, including typical service settings, procedure scope, common modifiers used in billing practice, and where this code sits in relation to other otologic procedures. The publication summarizes benchmarks and policy-relevant considerations that influence coverage and payment for tympanic membrane reconstruction, outlines common clinical indications and service-line implications, and flags areas where coding specificity matters for payer adjudication. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 69631 describes surgical reconstruction of the tympanic membrane (eardrum) to repair a perforation. The procedure can include reconstruction of the external auditory canal, an incision into the tympanic attic, and other middle ear surgical maneuvers intended to close and restore the integrity of the eardrum. The description specifies that the service does not include mastoid removal or reconstruction of the ossicular chain.
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Service type: Surgical repair of tympanic membrane perforation (middle ear surgery)
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Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in an inpatient setting when clinically indicated