Summary & Overview

CPT 69719: Bone-Anchored Auditory Implant Replacement, Mastoid

CPT code 69719 covers replacement of a bone-anchored skull implant that magnetically couples to an external speech processor to transmit sound to the inner ear. This procedure addresses implants situated in the mastoid or small bony defects (<100 sq mm) and is performed where surgical implant work is done, such as hospital ORs or ambulatory surgical centers. The code matters nationally because bone-anchored auditory systems affect hearing rehabilitation options for patients with conductive or mixed hearing loss and for single-sided deafness; reimbursement and coverage policies for implantable hearing devices influence access to these advanced interventions.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical settings and service type, and what to expect in benchmarking and policy discussions where available. The publication covers claim-line considerations, common modifier usage (listed separately), and clinical context for when replacement of a transcutaneous magnetically coupled implant is coded. Data not available in the input is noted where specific payer policies, associated taxonomies, ICD-10 diagnoses, and related codes would normally appear.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 69719bone-anchored implantauditory implantmastoid surgeryimplant replacementotologic surgeryhearing rehabilitation

Billing Code Overview

CPT code 69719 describes replacement of a bone-anchored implant in the skull that converts sound energy for reception by the inner ear. The device is implanted in the mastoid and/or addresses a bony defect with surface area under 100 square millimeters. The implant type is magnetically coupled to a speech processor and is transcutaneous, functioning through closed skin.

Service type: Implantable auditory prosthesis replacement

Typical site of service: Hospital operating room or ambulatory surgical center, with the procedure focused on the mastoid portion of the skull adjacent to the ear.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with long-standing conductive hearing loss and a previously implanted bone-anchored hearing device presents with device failure and declining aided hearing. The patient undergoes preoperative assessment including audiometry, otologic exam, and CT of the temporal bones that confirms an intact mastoid bone and a bony defect of less than 100 sq mm at the implant site. The otologic surgeon schedules a replacement of the skull (bone-anchored) implant that is magnetically coupled transcutaneously to a speech processor. The procedure typically occurs in an ambulatory surgical center or hospital operating room under general anesthesia. Intraoperative steps include surgical exposure of the mastoid implant site, removal of the failed implant components, inspection of the bone bed and any small bony defects, placement of the replacement magnetically coupled implant in the mastoid or over the small bony defect, confirmation of proper seating and magnet coupling, and layered wound closure. Postoperative workflow includes routine PACU recovery, wound checks, audiology fitting and magnet strength adjustment of the external speech processor at a follow-up visit, and documentation of device replacement details in the operative report.

Coding Specifications

Modifier	Description	When to Use
`11`	Subsequent performance of a procedure by the same physician	When this replacement is performed by the same surgeon who performed the original implant and post-op care is part of global period billing.

Taxonomy Code	Specialty	Notes
2080S0005X	Otolaryngology (ENT)	Primary specialty performing mastoid/cranial bone-anchored implant replacements.
2080P0207X	Neurotology	Subspecialists who manage complex temporal bone anatomy and revisions.
2086S0121X	Plastic and Reconstructive Surgery	May participate when soft-tissue reconstruction or complex scalp closure is required.
2085R0203X	Audiology	Audiologists perform postoperative device fitting, magnet strength adjustments, and audiometric verification.

CPT Code	Description	Relationship to This Procedure
`69714`	Removal of implantable bone conduction hearing device (extracranial)	May be performed prior to or during replacement if explantation of failed hardware is required.
`69930`	Surgical exploration of cranial nerve (e.g., internal auditory canal) — (note: code used for complex cranial procedures)	May be used if additional cranial exploration or risky dissection is required during a complex replacement (use only when applicable).
`92620`	Evaluation of auditory function following treatment with implantable hearing device; programming and mapping	Performed by audiology for postoperative activation, programming and mapping of the external speech processor after implant replacement.
`69210`	Removal of impacted cerumen (for ear canal preparation)	Occasionally performed in the perioperative or clinic setting to optimize external processor coupling during follow-up (adjunctive outpatient service).
`99100`	Anesthesia for patient of extreme age, under 1 year	Only applicable if pediatric cases require special anesthesia reporting (use when anesthesiology rules require).

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