CCSD code D1520 – Suction clearance of middle ear (sole procedure)

Key takeaways

CCSD code D1520 covers suction clearance of the middle ear, billed only when it is the sole procedure in the session.

The CCSD schedule bars D1520 from a claim with 12 codes, including D1510, D1530 and D0702 aural toilet.

If a grommet goes in or the drum is cut, bill the code for that work instead of D1520.

The ENT note should record the indication, the access route, the side and that nothing else was done.

Fees differ widely, with Bupa paying £123 and Freedom Health Insurance £50, so check each schedule first.

CCSD code D1520 covers middle ear suction and nothing else

CCSD code D1520 is the UK private billing code for suction clearance of the middle ear. It sits in the ear, nose and throat chapter, under section 5.2.0 Middle ear and mastoid. The full descriptor reads “Suction clearance of middle ear (as sole procedure)”.

Those last three words carry the rule. D1520 fits a session where suction of the middle ear is the only procedure. Once the surgeon does more, such as inserting a tube, the claim needs a different code.

The suction reaches the middle ear through an opening that already exists, like a perforation or a tube. If the surgeon has to cut the drum first, that cut is a myringotomy. Myringotomy has its own codes, and neither can share a claim with D1520.

Twelve codes can never share a claim with D1520

The CCSD schedule lists these codes as unacceptable combinations with D1520. Each one either works on the same ear structures or already includes clearing the ear.

• D0702: aural toilet, including microsuction or suction of an exteriorized mastoid cavity.
• D0730: removal of a foreign body from the external auditory canal.
• D1420: myringoplasty.
• D1440: combined approach tympanoplasty.
• D1510: myringotomy and insertion of a tube through the tympanic membrane.
• D1530: myringotomy.
• D1610: ossiculoplasty.
• D1710: stapedectomy.
• D1720: revision stapedectomy.
• D1900: middle ear tumor excision.
• D1910: middle ear polypectomy.
• D2040: diagnostic tympanotomy as a sole procedure.

The CCSD Group describes its coding principles as guidance, not an exhaustive rulebook. Each insurer decides which combinations it adopts. So read the insurer’s own rules before you bill D1520 next to any other ear code.

D1520, D1510 and D0702 look alike but bill differently

Three neighboring codes cause most of the confusion. The descriptor, not the code number, tells you which one the note supports.

Bupa figures come from our Bupa procedure codes fee schedule reference, February 2026 edition. Notice that D1520 pays more than D0702 at Bupa. That makes the boundary an audit target, so the note has to show the suction went beyond the ear canal.

The ENT note has to prove suction was the whole procedure

Insurers query D1520 when the note leaves room for a second procedure. Before the claim goes out, check that the record covers each point below.

• Indication and diagnosis: the condition and its ICD-10 code, for example suppurative otitis media (H66).
• Findings: what the microscope showed in the middle ear, such as discharge or debris.
• Access route: the perforation or existing tube the suction passed through.
• Side treated: right, left or both.
• What was removed: the material cleared, and whether a sample went for culture.
• Sole procedure: a plain statement that no other procedure was done.
• Anesthetic and consent: local or general anesthetic, and the signed consent form.

The sole procedure line matters most. Without it, an auditor can read the canal cleaning or the tube check as separate work.

Booked for suction, left with a grommet? Bill what was done

Here is a case billing teams meet often. An adult with a long-standing perforation is booked for D1520 under the microscope. During the session, the surgeon decides the ear needs ventilation and places a tube.

The session is no longer suction as a sole procedure. Bill the procedure performed, which here is D1510, and drop D1520 from the claim. The two codes are a barred pair, so billing both invites a rejection.

Then tell the insurer the code changed and ask it to update the authorization. The note should explain the finding that changed the plan. That way, the note, the authorization and the claim all describe the same work.

How a D1520 claim moves from note to insurer

Once the note is right, the claim follows a predictable path. Each step has its own way of tripping up a middle ear claim.

1. Check cover and authorization. Confirm the policy covers the procedure and record the authorization number.
2. Write the note on the day. Capture the findings, the side and the sole procedure statement while they are fresh.
3. Confirm the code. Suction alone means D1520. A tube, an incision or canal-only cleaning means another code.
4. Build the invoice. Add the CCSD code, ICD-10 code, procedure date, membership number and authorization number.
5. Submit electronically. Most UK insurers receive specialist invoices through Healthcode.
6. Reconcile the payment. Compare the remittance with the insurer’s schedule and follow up any short payment.

Each insurer prices D1520 its own way

The CCSD Group maintains the CCSD codes specialists bill, but it does not set fees. Each insurer decides its own fee, band and authorization rules for D1520.

The spread can be wide. Bupa places D1520 in MINOR 2 at £123. Freedom Health Insurance lists it as Minor complexity, with a £50 specialist fee and a £129 anesthetist fee. Check the current schedule for the patient’s policy before the procedure.

Common D1520 mistakes and the fix for each one

Most rejected D1520 claims trace back to a handful of errors. Each one has a simple fix.

Run this checklist before the D1520 claim goes out

A two-minute check catches most of the problems above. Run it on every middle ear suction invoice.

• The note says suction of the middle ear was the only procedure.
• The note names the access route and the side treated.
• None of the 12 barred codes appears on the same claim.
• The ICD-10 code matches the indication in the note.
• The authorization covers D1520, or the insurer has updated it.
• The fee you expect matches the insurer’s current schedule.

How Pabau keeps D1520 claims tied to the ENT note

In many ENT practices, the clinical note lives in one system and the invoice in another. A biller then copies the code, the side and the authorization number across by hand.

Pabau, the practice management and billing platform we build, keeps both on the same patient record. With claims management, the CCSD code, membership number and authorization reference carry into the claim. Pabau checks the required fields, then sends the invoice to Healthcode.

You then follow each claim’s status and payment in one place. Your team stops re-keying, and a missing authorization number gets caught before the insurer sees it.

Send clean CCSD claims straight to Healthcode

Pabau builds CCSD claims like D1520 from the patient record and checks required fields before submission. Then you can track each claim’s status in one place.

Book a demo

Conclusion

D1520 rewards one habit. Before you code, ask whether suction of the middle ear was the only thing done. If the answer is yes, the code fits. If anything else happened, the other procedure takes the claim.

Get the note to say that plainly on the day. When it names the access route, the side and the sole procedure, the insurer has little left to query.

Book a demo to see how Pabau carries a D1520 claim from the ENT note to Healthcode without retyping.

Continue your research

Billing a myringotomy instead? CCSD code D1530 covers an eardrum incision with no tube left in.

Did a grommet go in? CCSD code D1510 explains myringotomy with tube insertion.

Taking a grommet out? CCSD code D2030 covers removal of grommets.

Coding other ENT surgery? CCSD code E4100 explains voice prosthesis insertion from the same chapter.

Want every Bupa code in one place? Bupa CCSD codes sets out the schedule and how its codes are organized.

Frequently asked questions