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An endolymphatic sac operation is a surgical procedure aimed at addressing Meniere's disease, a condition characterized by episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of fullness in the ear. This operation can be performed with or without the placement of a shunt. In the case of CPT® Code 69805, the procedure is conducted without a shunt. The surgery involves the opening of the mastoid bone, which is located behind the ear. During the operation, the sigmoid sinus, an S-shaped cavity situated behind the mastoid bone, is carefully denuded of bone, leaving a small area known as Bill's island intact. This removal of bone is crucial as it allows the endolymphatic sac to expand, thereby alleviating the pressure that is believed to contribute to the symptoms associated with Meniere's disease. The endolymphatic sac, which is located behind the semicircular canal, is then exposed, and the surgical intervention focuses on relieving the symptoms by addressing the underlying issues within the inner ear.
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The endolymphatic sac operation is indicated for patients suffering from Meniere's disease, which is characterized by the following symptoms:
The endolymphatic sac operation without shunt involves several key procedural steps:
After the endolymphatic sac operation, patients are typically monitored for any immediate complications. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Patients can expect a recovery period during which they may experience some discomfort or changes in hearing. Follow-up appointments are essential to assess the success of the procedure and to monitor for any recurrence of symptoms associated with Meniere's disease.
| Short Descr | EXPLORE INNER EAR | Medium Descr | ENDOLYMPHATIC SAC W/O SHUNT | Long Descr | Endolymphatic sac operation; without shunt | 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) | 2 - Payment restriction for assistants at surgery does not apply 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 26 - Other therapeutic ear procedures |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 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. | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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