CCSD code D1060 – Revision of mastoidectomy

Key takeaways

CCSD code D1060 covers revision of mastoidectomy, including meatoplasty, in Chapter 5 Ear, nose and throat.

Previous surgery on the same mastoid is what points the claim to D1060, whichever mastoidectomy came first.

CCSD lists D0340, D1010, D1020, D1040 and D1240 as unacceptable combinations with D1060.

WHO ICD-10 codes such as H95.0 and H95.1 describe the usual reasons for a revision.

Fees and pre-authorization rules for D1060 differ by insurer, so check each schedule before surgery.

CCSD code D1060: The revision mastoidectomy code explained

CCSD code D1060 is the UK private insurance code for revision of mastoidectomy (including meatoplasty). Surgeons use it when they operate again on a mastoid that has already been drilled. The meatoplasty, which widens the outer ear canal opening, is part of the code.

D1060 sits in Chapter 5, Ear, nose and throat, under section 5.2, Middle Ear and Mastoid. Private medical insurers such as Bupa, AXA Health, Aviva and Vitality use the CCSD schedule to identify surgical procedures. The CCSD code library lists the neighboring ear procedures.

• Descriptor: Revision of mastoidectomy (including meatoplasty)
• Chapter: 5 Ear, nose and throat
• Section: 5.2 Middle Ear and Mastoid
• Included work: Meatoplasty, so it is never billed on a separate line

Why surgeons go back into an operated mastoid

A revision follows an earlier mastoidectomy that did not fully solve the problem. The commonest reason is cholesteatoma that has come back or was left behind. Another is a mastoid cavity that keeps discharging despite regular cleaning.

A narrow ear canal opening can also trap debris in an open cavity. That is why the revision code carries the meatoplasty with it. The surgeon widens the opening during the same operation.

The diagnosis on the claim should explain why the surgeon went back in. These WHO ICD-10 codes fit most D1060 claims:

• H95.0 Recurrent cholesteatoma of postmastoidectomy cavity
• H95.1 Other disorders following mastoidectomy, such as a chronically inflamed cavity
• H71 Cholesteatoma of middle ear, where disease extends beyond the old cavity

Quick check: Did the surgeon only clean the cavity? Then no revision took place, and D1060 does not apply. Did they reopen and re-drill the mastoid? Then D1060 is the code.

The decision tree below runs both checks and sends a first operation to its own primary code.

Previous surgery, not the canal wall, decides D1060

The primary mastoid codes depend on how much bone and middle ear the surgeon removes. D1060 works differently. Its descriptor names no mastoidectomy type, so any repeat operation on an operated mastoid falls under it.

Descriptors match the CCSD narratives as printed in the Allianz Worldwide Care UK fee schedule. A first operation with the canal wall standing goes to D1040. Combined approach surgery that keeps the wall is D1440.

Five codes that cannot share a claim with D1060

CCSD flags certain pairs as unacceptable combinations. Insurers can reject a claim that bills both codes in the same episode. For D1060, the list covers the other mastoid operations and two procedures the revision already includes.

Planning another procedure in the same sitting? Check it against the CCSD combination list before you add it to the claim.

A D1060 claim, walked through

Take a patient who had a canal wall down mastoidectomy on the left ear three years ago. The cavity now holds recurrent cholesteatoma, and the canal opening has narrowed. The surgeon clears the disease and widens the opening.

1. Code the operation as D1060, because the mastoid was operated on before.
2. Leave D0340 off the claim. The meatoplasty is already inside D1060.
3. Do not add D1010, even though the cavity is a radical-type cavity.
4. Add H95.0 as the diagnosis, since the cholesteatoma recurred in the old cavity.
5. Quote the pre-authorization number the insurer issued before surgery.

The anesthetist bills separately, under the same CCSD code with their own fee.

What the operative note needs to prove

Insurers query revision claims when the note reads like a first operation. The record should make the earlier surgery obvious to a reviewer who has never seen the patient.

• The side operated on, left or right
• The date and type of the previous mastoidectomy
• Findings that justify the revision, such as recurrent cholesteatoma or a discharging cavity
• What was done in the cavity, including the meatoplasty
• The diagnosis code that matches those findings

D1060 fees and pre-authorization depend on the insurer

Each insurer publishes its own fee for D1060 and updates it on its own timetable. Check your contracted rate in the insurer’s current schedule rather than relying on another insurer’s figure.

Rules for extra procedures vary too. Allianz Worldwide Care’s UK schedule pays 100% of the main procedure fee and 50% of a second procedure under the same anesthetic. Other insurers set their own percentages.

Most UK private medical insurers expect pre-authorization before elective surgery. Request it with the planned code and diagnosis, and keep the reference for the claim. The prior authorization process guide covers each step.

Before you submit a D1060 claim

• The record shows an earlier mastoidectomy on the same side.
• The surgeon re-operated on the mastoid rather than cleaning it.
• No D0340, D1010, D1020, D1040 or D1240 line appears on the claim.
• Any extra procedure has been checked against the CCSD combination list.
• A diagnosis such as H95.0, H95.1 or H71 is attached.
• The pre-authorization number and membership number are on the claim.

D1060 mistakes that send claims back

Returned claims still cost time to rework. A short denial management routine helps you spot repeat reasons.

How Pabau keeps D1060 claims on track

Many ENT practices still copy codes, membership numbers and pre-authorization references into an insurer portal by hand. One missed field sends the claim back.

Pabau sends CCSD claims through its Healthcode integration. Its private practice claims software fills the claim from the patient record. It checks required fields, such as membership and authorization numbers, before the claim goes out.

After submission, you can follow each claim to payment in the same system. Insurer details collected on intake forms are already in the record when the claim opens.

Send ENT surgery claims through Healthcode

Pabau fills CCSD claims from the patient record, checks required fields such as pre-authorization numbers, and tracks each claim to payment.

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Conclusion

D1060 turns on one question: has this mastoid been operated on before? If it has, the claim carries D1060 and nothing for the meatoplasty or the primary mastoid codes.

Before the claim goes out, make sure the record names the earlier operation. The claim itself needs a matching diagnosis and the pre-authorization number. A reviewer then has no reason to read the revision as a first operation.

Book a demo to see how Pabau sends ENT claims through Healthcode with every required field filled.

Continue your research

Coding a first mastoid operation? CCSD code D1040: Simple mastoidectomy billing guide explains when the canal wall stays up and the claim stays at D1040.

Clearing disease with the canal wall intact? CCSD code D1440: Intact canal wall tympanoplasty billing guide covers combined approach surgery and how it differs from canal wall down work.

Billing ENT procedures to Bupa? Pabau’s Bupa CCSD codes guide walks through how Bupa uses the CCSD schedule.

Seeing the same rejection twice? Denial management in healthcare sets out a routine for tracking and fixing returned claims.

Frequently asked questions