CPT® Code 69700

A postauricular mastoid cutaneous fistula is a pathological opening that can occur behind the ear, often resulting from chronic infections affecting the middle ear or the mastoid air cells. This condition may also arise as a complication following previous surgical interventions on the ear or mastoid region. The procedure coded as CPT® 69700 involves the surgical closure of this type of fistula, which is classified as a separate procedure. During the closure, the surgeon may choose to excise the entire fistula or freshen the edges of the opening to create a raw surface that promotes healing. A skin flap is then meticulously crafted beneath the fistula, with its pedicle positioned at the upper part of the flap. This flap is rotated upward and inserted into the fistula, ensuring that the skin surface faces inward. The surgeon secures the flap in place using sutures, and subsequently, the raw edges of the fistulous opening are closed over the newly placed skin flap. This technique results in an epithelial covering on both the internal and external surfaces of the fistulous tract, facilitating proper healing. Alternatively, the closure may involve the creation of periosteal flaps that serve to cover the fistula, which are then further covered with skin flaps to ensure adequate closure and healing of the affected area.