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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. The procedure involves accessing the mastoid bone, which is located behind the ear, to reach the endolymphatic sac, a structure within the inner ear that plays a crucial role in maintaining balance and hearing. During the operation, the mastoid bone is surgically opened to allow for better visualization and access to the endolymphatic sac. In the context of CPT® Code 69806, the procedure specifically includes the insertion of a shunt. This shunt is designed to facilitate the drainage of excess fluid from the endolymphatic sac, thereby alleviating the pressure that contributes to the symptoms of Meniere's disease. The shunt is equipped with a one-way valve, which permits fluid to escape from the sac while preventing any backflow, thus helping to manage the fluid dynamics within the inner ear effectively.
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The endolymphatic sac operation with shunt is indicated for patients suffering from Meniere's disease, which is characterized by the following symptoms:
The endolymphatic sac operation with shunt involves several key procedural steps that are critical for its success:
After the endolymphatic sac operation with shunt, patients typically require monitoring for any immediate complications. Post-procedure care may include pain management, instructions for activity restrictions, and follow-up appointments to assess the success of the shunt placement. Patients may experience some swelling and discomfort in the area of the incision, which is expected and can be managed with prescribed medications. It is important for patients to report any unusual symptoms, such as increased dizziness or changes in hearing, to their healthcare provider. Recovery times can vary, but many patients are able to return to normal activities within a few weeks, depending on their individual healing process and the specific recommendations of their surgeon.
| Short Descr | EXPLORE INNER EAR | Medium Descr | ENDOLYMPHATIC SAC SHUNT | Long Descr | Endolymphatic sac operation; with 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) | 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) | P1G - Major procedure - 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). | 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). | 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) | SG | Ambulatory surgical center (asc) facility service |
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