Basics of CPT code 69716, 69719, 69726 & 69727

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. In 2022, the Audiology section saw changes within the osseointegrated implant procedures, with deletions of codes 69715 and 69718, revisions of CPT code 69714 and 69717 and new CPT code 69716, 69719, 69726 and 69727.

• Code 69716 describes the implantation of the osseointegrated implant.
• Code 69719 describes the replacement including removal of the implant.
• Code 69726 describes the removal of the osseointegrated implant with percutaneous attachment to an external speech processor.
• Code 69727 describes the removal of the osseointegrated implant with magnetic transcutaneous attachment to an external speech processor.

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Description of CPT code 69716, 69719, 69726 & 69727

69714 Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor

69716 with magnetic transcutaneous attachment to external speech processor

69717 Revision or replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor

69719 with magnetic transcutaneous attachment to external speech processor
69726 Removal, osseointegrated implant, skull; with percutaneous attachment to external speech processor
69727 with magnetic transcutaneous attachment to external speech processor

The physician implants a bone-anchored hearing aid into the skull. Bone conduction implants transfer sound to the inner ear through direct vibration of the skull. The implant is attached to a percutaneous abutment or to a transcutaneous magnet that directly communicates with the external sound processor. The implant, which may be made of titanium or other materials, stimulates the cochlea through direct bone conduction. The sound processor transforms sound into vibrations; these are transferred by the implant to the skull bone and then to the cochlea. In one implantation procedure, reported with CPT code 69714, the physician makes a small break in the skin to expose the mastoid cortex, and a skin flap and periosteal flap are created. A tunnel is drilled and tapped to create a passage for the stem of the implant pedestal. The stem is placed in the tunnel adjacent to the cochlea and the abutment is attached and secured to the stem. The soft tissue surrounding the pedestal is thinned to prevent local movement and minimize the incidence of infection at the site. The implant remains in place and fuses, or osseointegrates, with the living bone. An alternative to percutaneous attachment to the external speech processor is a transcutaneous magnetic bone-conduction implant, reported with CPT code 69716. In one procedure, the physician creates a subcutaneous pocket over the skull to house the device. A periosteal incision is made to expose the cortex. The device is secured to the cortex and a multilayer site closure is performed. The acoustic transmission occurs by the magnetic attachment of the external sound processor and the internally implanted device components. Since the processor adheres magnetically to the implanted device, no percutaneous abutment is necessary to connect the internal and external components. CPT code 69717 is reported for revision or replacement of the implant with percutaneous attachment to the external speech processor and 69719 if the external speech processor features a magnetic percutaneous attachment. Both codes include removal of the existing device. CPT code 69726 is reported for removal only of the implant with a percutaneous external speech processor attachment and 69727 if the speech processor features a magnetic percutaneous attachment. In all scenarios, if a mastoidectomy is performed during the same operative session, it is reported separately.