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CPT®
69820

CPT® Code 69820
Deleted

Official Description

Fenestration semicircular canal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 69820, known as fenestration of the semicircular canal, involves a surgical intervention aimed at addressing issues related to conductive hearing loss. This procedure is characterized by the creation of a small opening, or fenestration, in the lateral semicircular canal, which is part of the inner ear structure. The fenestration is intended to facilitate the transmission of sound waves by bypassing the stapes footplate, a small bone in the middle ear that can become fixed or immobile, thereby impeding normal hearing. The surgical approach typically utilized is a transmastoid approach, which involves accessing the ear through the mastoid bone located behind the ear. During the procedure, a mastoidectomy is performed using a wall down technique, which entails the removal of bone to create a single cavity that encompasses both the mastoid and the ear canal. This technique allows for better visualization and access to the semicircular canal. Once the lateral semicircular canal is identified, the surgeon creates the fenestration and places a fascial graft over the opening to support the structure and promote healing. Although this procedure was more commonly performed in the past, it is now less frequently utilized in contemporary medical practice. The fenestration procedure is sometimes revised, as indicated by CPT® Code 69840, which involves addressing any complications or issues related to a previously performed fenestration.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The fenestration of the semicircular canal, as described by CPT® Code 69820, is indicated for specific conditions related to conductive hearing loss. The following are the primary indications for this procedure:

  • Conductive Hearing Loss This procedure is performed to treat conductive hearing loss, which occurs when sound waves are not effectively transmitted through the outer ear canal to the eardrum and the tiny bones of the middle ear.

2. Procedure

The procedure for fenestration of the semicircular canal involves several critical steps, each designed to ensure the successful creation of the fenestration and the restoration of hearing. The following outlines the procedural steps:

  • Step 1: Transmastoid Approach The surgeon begins by accessing the ear through a transmastoid approach. This involves making an incision behind the ear to expose the mastoid bone, which is located just behind the ear canal.
  • Step 2: Mastoidectomy A mastoidectomy is performed using a wall down technique. This technique requires the removal of bone from the back of the ear canal, creating a single cavity that includes both the mastoid and the ear canal. This approach provides the surgeon with better access to the inner ear structures.
  • Step 3: Identification of the Lateral Semicircular Canal Once the cavity is created, the surgeon carefully identifies the lateral semicircular canal, which is crucial for the next step of the procedure.
  • Step 4: Creation of the Fenestration A small hole or fenestration is then made in the lateral semicircular canal. This fenestration allows sound to bypass the fixed stapes footplate, facilitating sound transmission through the canal and into the cochlea.
  • Step 5: Placement of the Fascial Graft After the fenestration is created, a fascial graft is placed over the opening. This graft serves to support the structure of the canal and promote healing following the procedure.

3. Post-Procedure

Post-procedure care following a fenestration of the semicircular canal typically involves monitoring the patient for any complications and ensuring proper healing of the surgical site. Patients may experience some discomfort or temporary changes in hearing as they recover. Follow-up appointments are essential to assess the success of the procedure and to address any concerns that may arise. The surgeon may provide specific instructions regarding activity restrictions, pain management, and signs of potential complications that should prompt immediate medical attention.
Short Descr ESTABLISH INNER EAR WINDOW
Medium Descr FENESTRATION SEMICIRCULAR CANAL
Long Descr Fenestration semicircular canal
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 26 - Other therapeutic ear procedures
Date
Action
Notes
2017-12-31 Deleted Code deleted.
Pre-1990 Added Code added.
Code
Description
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Description
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