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CPT 69633: Tympanic Membrane and Ossicular Reconstruction with Prosthesis
CPT code 69633 represents an otologic reconstructive operation that combines tympanic membrane repair (tympanoplasty) with ossicular chain reconstruction using a synthetic prosthesis. This procedure addresses conductive hearing loss due to tympanic membrane perforation and ossicular disruption and is performed in an operating room setting without mastoid cavity removal. Nationally, this code matters because it captures a distinct combined reconstructive service that influences surgical resource use, specialty reimbursement patterns, and quality measurement in ear surgery.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 69633 is used, typical sites of service, and how the code differs from isolated tympanoplasty or ossicular procedures. The publication covers billing and policy considerations relevant to payers and provider organizations, benchmarks for frequency and utilization where available, and recent policy updates or documentation expectations that affect claim adjudication. Practical information on common modifiers and related coding considerations is included to help coding professionals and administrators ensure accurate claim submission.
Data not available in the input for specific ICD-10 pairings, payer-specific rates, and associated taxonomies are noted where applicable.
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Billing Code Overview
CPT code 69633 describes a surgical procedure in which the provider reconstructs the tympanic membrane (eardrum) to repair a perforation and reconstructs the ossicular chain to improve conductive hearing. The procedure includes placement of a synthetic ossicular prosthesis and may involve reconstruction of the ear canal and an attic tympanotomy or other middle ear surgeries. The description specifies that removal of the mastoid cavity is not included.
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Service type: Middle ear reconstructive surgery combining tympanoplasty and ossiculoplasty with prosthesis placement
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Typical site of service: Inpatient or outpatient surgical setting (operating room) for otologic surgery