Each year the AMA (American Medical Association) publishes new, revised, and deleted codes to the CPT code set, including logic and rationale related to the updates. The CPT code set for 2022 includes several changes regarding osseointegrated auditory implants. These changes include revisions of guidelines and parenthetical notes, as well as new, revised and deleted codes. The key changes regarding osseointegrated auditory implants for FY 2022 will be highlighted in this blog.

Osseointegrated Implants

Osseointegrated auditory implants/devices (OADs) are surgically implanted hearing devices that connect to an external processing device. Sound enters the device on the side of the impaired ear, which is then transmitted to the cochlea on the same side (for conductive or mixed hearing loss) or the opposite ear (in unilateral hearing loss) via a bone conduction implant.

 The external speech processor can be attached percutaneously or via a transcutaneous magnetic bone-conduction. A percutaneous device directly attaches the speech processor to the implant that protrudes through the scalp. A transcutaneous device couples the implant and the speech processor through an intact scalp via magnet. Below are illustrations of two percutaneous and two transcutaneous systems:

New Introductory Guidelines

A new osseointegrated implant subsection with introductory guidelines has been added, along with new parenthetical notes to guide users in the appropriate reporting of these procedures. The introductory guideline reads:

“The following codes are for implantation of an osseointegrated implant into the skull. These devices treat hearing loss through surgical placement of an abutment or device into the skull that facilitates transduction of acoustic energy to be received by the better-hearing inner ear or both inner ears when the implant is coupled to a speech processor and vibratory element. This coupling may occur in a percutaneous or a transcutaneous fashion. Other reparative middle ear and mastoid procedures (69501-69676) may be performed for different indications and may be reported separately, when performed.”

Revised, Deleted, and New Codes

Codes 69714 and 69717 have been revised with the removal of the term “temporal bones” and the phrase “cochlear stimulator without mastoidectomy.” 69717 now reads, “revision or replacement.” In 69714 and 69717, the external speech processor is attached percutaneously.

 69715 and 69718 have been deleted, with new parenthetical notes instructing coders to see 69501-69767 to report mastoidectomy performed at the same operative session as osseointegrated implant placement, revision, replacement, or removal.

New codes 69716 and 69719 have been added as child codes to 69714 and 69717 to report the magnetic transcutaneous attachment to an external speech processor for implantation, revision, or replacement of an osseointegrated implant.

• 69716 Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor

• 69719 Revision or replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor

New code 69726 has been established to report the removal of an osseointegrated implant with a percutaneous speech processor, and child code 69727 has been established to report the removal of an osseointegrated implant with a magnetic transcutaneous attachment.  

• 69726 Removal, osseointegrated implant, skull; with percutaneous attachment to external speech processor
  
• 69727 with magnetic transcutaneous attachment to external speech processor

Coding Tip

To report mastoidectomy performed at the same operative session as osseointegrated implant placement, revision, replacement, or removal, see 69501-69676. In addition to mastoidectomies, other reparative middle ear and mastoid procedures in 69501-69676 may be performed for different indications and may also be reported separately.

Additional Information

Additional information regarding osseointegrated implants and associated CPT updates for FY 2022 can be found below:

• American Medical Association (AMA) CPT 2022 Professional Edition (includes rules and guidelines from the AMA’s CPT Editorial Panel)
• AMA’s CPT Assistant, November 2021 Page: 5 “Temporal bone procedures to treat hearing loss”
• AMA’s CPT Assistant, October 2004 Pages: 2, 3 “Auditory system coding- mastoidectomy procedures”
• AMA’s CPT Assistant, October 2013 Page: 19 “Osseointegrated implant, temporal bone without attachment to external speech processor”
• AMA’s CPT Assistant, July 2020 Page: 3 “Auditory function services update”
• AHA Coding Clinic for HCPCS, Second Quarter 2010 Page: 6, 7 “BaHa® surgery without attachment to an external speech processor, correct reporting and First Quarter 2018 Page: 4 “BaHa® surgery without attachment to an external speech processor, clarification.”
• AHA Coding Clinic for HCPCS, Second Quarter 2020 Page: 9 “Implantation of Osia® system
• National Library of Medicine, Osseointegrated Auditory Devices: Bone-Anchored Hearing Aid and PONTO https://pubmed.ncbi.nlm.nih.gov/30617010/
• Science Direct, Placement of the Baha Osseointegrated Implant in Children https://www.sciencedirect.com/science/article/abs/pii/S1043181009000906
• SpringerLink, Implantable Hearing Devices https://link.springer.com/article/10.1007/s40137-014-0059-9