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The procedure described by CPT® Code 69801 is known as labyrinthotomy with perfusion of vestibuloactive drug(s) via a transcanal approach. This surgical intervention is primarily indicated for the treatment of Meniere's disease, a condition characterized by episodes of vertigo, tinnitus, and hearing loss due to abnormal fluid accumulation in the inner ear. The inner ear, or labyrinth, is a complex structure composed of both bony and membranous components, which play crucial roles in balance and hearing. The bony labyrinth provides a protective outer layer, while the membranous labyrinth contains the sensory organs responsible for these functions. Accessing the inner ear is achieved through a transcanal approach, which involves making an incision in the posterior aspect of the ear canal to elevate a tympanomeatal flap. This allows the surgeon to reach the middle ear and subsequently the labyrinth. The procedure involves meticulous dissection using an operating microscope and specialized surgical instruments to navigate through the delicate structures of the ear. Once the labyrinth is accessed, a needle or catheter is introduced into the inner ear, allowing for the direct instillation of vestibuloactive drugs aimed at alleviating the debilitating symptoms associated with Meniere's disease.
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The labyrinthotomy procedure with perfusion of vestibuloactive drug(s) is indicated for the treatment of Meniere's disease, which is characterized by the following symptoms and conditions:
The labyrinthotomy procedure involves several critical steps to ensure effective treatment. The first step is to access the inner ear through a transcanal approach. This begins with an incision made in the posterior aspect of the ear canal, allowing for the elevation of a tympanomeatal flap. This flap provides access to the middle ear, which is essential for the subsequent steps of the procedure. Following this, an incision is made behind the ear to expose the mastoid bone, which is crucial for navigating to the inner ear structures. The surgeon utilizes an operating microscope and microscopic surgical tools to carefully traverse the middle ear, ensuring minimal trauma to surrounding tissues. Once the bony labyrinth is reached, the surgeon opens both the bony and membranous labyrinth to gain access to the inner ear. The final step involves the placement of a needle or catheter into the inner ear, through which vestibuloactive drugs are instilled. These drugs are specifically chosen to alleviate the symptoms associated with Meniere's disease, providing relief to the patient.
After the labyrinthotomy procedure, patients may require monitoring for any immediate post-operative complications. Expected recovery includes a period of rest and observation to assess the effectiveness of the drug perfusion and to manage any potential side effects. Patients may experience some discomfort or temporary changes in hearing, which should be communicated to their healthcare provider. Follow-up appointments are essential to evaluate the success of the procedure and to determine if additional treatments are necessary. It is important for patients to adhere to post-operative care instructions provided by their healthcare team to ensure optimal recovery and symptom management.
| Short Descr | INCISE INNER EAR | Medium Descr | LABYRINTHOTOMY TRANSCANAL | Long Descr | Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 0 - 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 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 26 - Other therapeutic ear procedures |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | SG | Ambulatory surgical center (asc) facility service | 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. | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | 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 | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | CR | Catastrophe/disaster related | ER | Items and services furnished by a provider-based, off-campus emergency department | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2016-01-01 | Changed | Code description changed. |
| 2011-01-01 | Changed | Long description revised. Guideline information changed. |
| Pre-1990 | Added | Code added. |
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