CPT for Operating Microscope
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.
Important Disclaimer Notice (Updated 8/7/14)
CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures. These articles are not intended as legal, medical, or business advice and are not a guarantee of reimbursement. The information is also not meant to serve as the definitive or sole authority on billing and coding issues. The applicability of AAO-HNS billing and coding guidance for a particular procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. You should consult with your own advisors as well as Medicare or private carriers in making any decisions about how to bill and code particular services or procedures.