Q: Can I bill for use of the operating microscope, Code 69990?
A: Yes. Otolaryngologists commonly use the operating microscope while performing microsurgical procedures of the ear and auditory canal. CPT 69990, Use of operating microscope ( list separately in addition to code for primary procedure), is a billable CPT code. This code should be billed with surgical procedures that require use of a surgical microscope in order to perform techniques of microsurgery, when not an inclusive part of the major procedure. As an add-on code it will not require use of the –51 modifier.
The CPT Editorial Panel designed CPT 69990 to replace codes 61712 and 64830 along with the CPT microsurgery modifier –20. However, according to the Federal Register entry of 07/22/1999, Medicare will not pay for CPT 69990 for otolaryngology. It only allows this code to be billed with a handful of neurology codes, which are not commonly used by otolaryngologists. With private insurance carriers, CPT 69990 is more likely to be paid. According to the 2001 CPT Professional Edition, CPT code 69990 is not excluded from use with series 69000 through 69799. Your billing strategy should be geared to your best payors, even if only a small percentage, rather than your worst payors. Use the code appropriately and document to support your billings.
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