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A stapes mobilization is a surgical procedure aimed at restoring the movement of the stapes bone, which is one of the three tiny bones in the middle ear responsible for transmitting sound vibrations to the inner ear. Under normal circumstances, the stapes vibrates freely, allowing sound waves to be effectively conducted. However, in certain conditions, particularly otosclerosis, the stapes can become fixed due to abnormal bone growth on the walls of the inner ear. This fixation leads to conductive hearing loss, as the sound transmission is impeded. The procedure begins with an incision made in the posterior aspect of the external ear canal wall, followed by the creation of a tympanomeatal flap. This flap is then elevated to expose and inspect the ossicles of the middle ear. During the stapes mobilization, a specialized hook is utilized, which is placed against the long process of the incus. The hook is maneuvered towards the stapes tendon to release any attachments that may be causing the stapes to be fixed in place. After the mobilization is successfully completed, the tympanomeatal flap is repositioned, and the incision in the meatus is closed with sutures, ensuring proper healing and restoration of function.
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The stapes mobilization procedure is indicated for patients experiencing conductive hearing loss due to the fixation of the stapes bone, primarily caused by otosclerosis. This condition is characterized by abnormal bone growth that restricts the normal movement of the stapes, leading to impaired sound transmission. The procedure is typically recommended when conservative treatments have failed to improve hearing, and surgical intervention is deemed necessary to restore auditory function.
The stapes mobilization procedure involves several critical steps to ensure the successful restoration of movement to the stapes bone. Initially, the surgeon makes an incision in the posterior aspect of the external ear canal wall. This incision allows access to the middle ear structures. Following the incision, a tympanomeatal flap is created, which is a section of the ear canal skin that is elevated to expose the underlying ossicles of the middle ear. Once the flap is elevated, the surgeon inspects the ossicles to assess their condition and identify any fixation of the stapes. The next step involves the use of a specialized hook, which is carefully placed against the long process of the incus, another bone in the middle ear. The surgeon then moves the hook in the direction of the stapes tendon, applying gentle pressure to release any attachments that may be causing the stapes to be fixed. This step is crucial for restoring the mobility of the stapes. Upon successful mobilization, the tympanomeatal flap is replaced to its original position, and the incision in the meatus is closed with sutures to promote healing and restore the integrity of the ear canal.
After the stapes mobilization procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management and instructions for keeping the ear dry to prevent infection. Patients are advised to avoid activities that may increase pressure in the ear, such as heavy lifting or straining. Follow-up appointments are essential to assess the healing process and evaluate the improvement in hearing. The expected recovery time can vary, but many patients experience a gradual improvement in hearing as the ear heals.
| Short Descr | STAPES MOBILIZATION | Medium Descr | STAPES MOBILIZATION | Long Descr | Stapes mobilization | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 26 - Other therapeutic ear procedures |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2025-01-01 | Changed | Short Description changed. |
| 2003-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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