Summary & Overview
CPT 69700: Closure of Postauricular Fistula of Mastoid
CPT code 69700 represents the surgical closure of a postauricular fistula of the mastoid, a focused otologic soft-tissue procedure involving excision of the skin plug containing the fistula and suturing of the incision. This code is used when the procedure is performed as a separate service and typically applies to procedures in ambulatory surgical centers, hospital outpatient departments, or office-based surgical suites. Nationally, correct coding of 69700 matters for accurate surgical case capture, appropriate payment for otologic procedures, and consistent clinical documentation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for this otologic closure procedure, typical sites of service, and which payers commonly cover or process claims for this CPT code. The publication also provides benchmarking guidance, common billing considerations, and a summary of policy and reimbursement trends affecting surgical closures of postauricular fistulae. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 69700 describes the surgical closure of a postauricular fistula of the mastoid. The procedure involves excision of the skin plug that contains the fistula tract followed by suturing of the incision site. The description specifies that this is a separate procedure.
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Service type: Surgical excision and closure of a fistulous tract (otologic/periauricular soft-tissue surgery)
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Typical site of service: Ambulatory surgical center or hospital outpatient department, and may also be performed in an office-based surgical suite depending on clinical circumstance and facility capabilities.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to a tertiary otolaryngology clinic with a chronic draining postauricular sinus tract overlying the mastoid following prior mastoid surgery and recurrent localized infection. Examination demonstrates a small epithelialized fistulous opening behind the auricle with intermittent drainage and surrounding scarring. The patient is scheduled for operative closure: under monitored anesthesia care or general anesthesia, the surgeon excises the skin plug containing the fistula down to healthy tissue, performs minimal debridement of chronic granulation, and closes the wound in layered fashion with sutures. The procedure is typically performed in an outpatient ambulatory surgery center or hospital operating room. Preoperative steps include history and exam, relevant imaging review (CT temporal bone if indicated), informed consent, local antisepsis, and anesthesia evaluation. Postoperative workflow includes wound care instructions, short course antibiotics if indicated, and follow-up for suture removal and assessment of fistula closure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unmodified code | Use when no modifier applies and billing the standard service |
11 | Office or other outpatient visit |