AHA Coding Clinic® for HCPCS - 2022 Issue 4; Ask the Editor

Removal of scar tissue from external auditory canal with split-thickness skin graft

A patient with bilateral inflammation, infection and acquired stenosis of the external ear canal presents for excision of scar tissue and a split-thickness skin graft to the right ear. A postauricular incision was made and the skin and subcutaneous tissue were elevated to the spine of Henle and bony posterior canal where a retractor was placed. Once the canal wall skin was elevated off the underlying bone, the external auditory canal (EAC) was entered posteriorly via an incision and continued anteriorly. The lateral skin and soft tissue of the EAC were elevated over the tympanic bone, while the medial was elevated off the canal wall bone. Soft scar tissue was removed from the meatus and lateral two-thirds of the EAC. A drill was used to create two deep troughs, superior and inferior, exposing the annulus. The anterior canal wall between both troughs was removed and the troughs were connected.A 10x10 cm area on the right thigh was prepared for graft harvesting and a 5x2 cm area of skin was marked. A dermatome was used to harvest the 5x2 cm split-thickness skin graft. The graft was divided in half and placed along the anterior and posterior canal walls. The canal was packed to secure the graft in place. The postauricular incision was closed in a muscular/deep dermal layer and the skin closed in a subcutaneous manner. How is excision of scar tissue from the external auditory canal and split-thickness skin graft reported? Is it appropriate to assign additionally CPT code 15002 for the preparation of the recipient site? ...

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