CPT® Code 69155

The procedure described by CPT® Code 69155 involves a radical excision of a lesion located in the external auditory canal, accompanied by a neck dissection. This surgical intervention is necessary when a lesion has begun to invade surrounding structures, necessitating the removal of not only the lesion itself but also a margin of healthy tissue to ensure complete excision. The procedure is performed with careful consideration to protect the facial nerve, which is critical for facial movement and expression. An incision is typically made in the external auditory canal, extending towards the front of the ear and into the parotid gland area. The excision includes the anterior portion of the lesion along with parts of the parotid gland, and may also involve a post-auricular incision to facilitate the removal of the tumor and any affected surrounding tissues, including the canal wall, external ear cartilage, and potentially bone. During the surgery, intraoperative frozen sections of the surgical margins are analyzed pathologically to check for tumor invasion. If any margins are found to be positive for tumor, additional piecemeal resection is performed to ensure that all visible and microscopic tumor evidence is eliminated. The procedure may also involve the removal of skin, soft tissue, cartilage, and bone as necessary. If reconstruction of the external auditory canal is required, this can be reported separately, particularly if skin grafts are utilized. It is important to note that CPT® Code 69150 is applicable when a radical excision is performed without a radical neck dissection, while CPT® Code 69155 is specifically used when a radical neck dissection is included in the procedure.