CPT® Code 69714

The CPT® Code 69714 refers to the procedure of implanting an osseointegrated implant in the skull, which includes the installation of a percutaneous attachment for an external speech processor. This procedure is primarily utilized in the context of bone conduction implants (BCI), which are designed to assist individuals with hearing impairments. The BCI system operates by using an external hearing aid or speech processor that amplifies sound. This amplified sound is then transmitted to an implant that is anchored to the skull, allowing sound vibrations to be conducted through the bone directly to the cochlea, the auditory portion of the inner ear. In the case of percutaneous implants, the surgical approach involves making an incision that can either be a vertical line measuring between 1 to 1.5 cm or a circular incision with a diameter of 5 mm. The surgical site is strategically planned to be at a height that aligns with the top of the auricle, typically around 5.5 cm from the ear canal. The procedure requires careful preparation, including the removal of hair from the surgical area and the use of a small gauge needle to measure the soft tissue depth down to the bony cortex. This measurement is critical as it informs the selection of the appropriate abutment size, which is determined by adding three millimeters to the measured depth. Local anesthesia is administered to ensure patient comfort during the procedure. The incision is then deepened to reach the bone, and the periosteum, a layer of connective tissue surrounding the bone, is elevated. Depth-gauging drill bits are employed to confirm that the bone thickness at the site is adequate for the implant. Once the correct depth is established, a countersink drill bit is utilized to create a well in the skull where the implant will be anchored. The implant is then securely placed, and if it does not come with a precoupled abutment, a separate abutment is attached to the implant. The surrounding soft tissue is meticulously closed in multiple layers, or alternatively, the surgical site may be closed entirely with the skin being removed over the abutment. This allows for the external speech processor and microphone to be affixed to the abutment, which is designed to permanently project from the patient's head, facilitating the connection to the external components of the hearing device.