Today, In the kNOW will be looking at an exciting emerging therapy highlighted in the April 2026 ICD-10-PCS updates—intracochlear administration of DB-OTO. This investigational treatment is a form of gene therapy designed to treat congenital hearing loss caused by mutations in the OTOF gene. The OTOF gene is responsible for producing otoferlin, a protein necessary for transmitting sound signals from the inner ear to the brain. When this gene is mutated, patients can experience profound hearing loss from birth.
The procedure involves delivering the DB-OTO therapy directly into the cochlea using an infusion catheter. The medication is administered locally to target the inner ear structures responsible for hearing. By introducing a functional copy of the gene, the therapy aims to restore the cellular mechanisms required for proper sound transmission.
The procedure involves delivering the DB-OTO therapy directly into the cochlea using an infusion catheter. The medication is administered locally to target the inner ear structures responsible for hearing. By introducing a functional copy of the gene, the therapy aims to restore the cellular mechanisms required for proper sound transmission.
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2400521
The first code to be assigned will come from the New Technology section for the temporary insertion of the infusion catheter. X9H(D,E, or F)01B would be the assigned codes. The body part values of D (right inner ear), E (left inner ear) or F (bilateral inner ear) would be selected as appropriate. Another New Technology code will be assigned for the DB-OTO component with code XW0E33B. The body part value E is for ear(s) so if the procedure is performed bilaterally, coding professionals should only assign one code.
From a coding perspective, an additional procedure code is assigned when the round window membrane is augmented with locally harvested tissue such as fascia, bone, or muscle during the procedure. This additional step supports the repair of the round window as it is perforated in order for the infusion catheter to reach the cochlea. From the Supplement table in Ear, Nose, Sinus-Medical and Surgical (body system and section)-09U, use body parts D or E for inner ear, right or left to capture the round window repair and to fully represent the services performed.
As gene therapies continue to advance, coding professionals will increasingly encounter procedures like DB-OTO administration that reflect cutting-edge treatment approaches. Understanding both the clinical purpose and the associated procedural components will be key to ensuring accurate code assignment and complete documentation.
From a coding perspective, an additional procedure code is assigned when the round window membrane is augmented with locally harvested tissue such as fascia, bone, or muscle during the procedure. This additional step supports the repair of the round window as it is perforated in order for the infusion catheter to reach the cochlea. From the Supplement table in Ear, Nose, Sinus-Medical and Surgical (body system and section)-09U, use body parts D or E for inner ear, right or left to capture the round window repair and to fully represent the services performed.
As gene therapies continue to advance, coding professionals will increasingly encounter procedures like DB-OTO administration that reflect cutting-edge treatment approaches. Understanding both the clinical purpose and the associated procedural components will be key to ensuring accurate code assignment and complete documentation.
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