Q: How Do I code for PE tube removal?
A: In January 2003, the American Medical Association (AMA) CPT Editorial Panel revised the coding for removal of tympanostomy (PE) tubes. Prior to the revision in January 2003, CPT code 69424 described: "ventilating tube removal when originally inserted by another physician." Post revision, the code descriptor for 69424 indicates “ventilating tube removal requiring general anesthesia.”
Physicians should bill CPT code 69424 for tube removal in the operating room only. If the physician removes PE tubes in the office, he or she should use an appropriate E/M CPT code. For any additional procedures performed simultaneously with this removal, submit appropriate modifiers, CPT, and ICD 9 CM codes.
NOTE: Removal of tympanostomy tubes in the office setting does not meet the criteria of a foreign body removal. If you remove a tube on the same date of service from the same ear for which a repair is performed (e.g. CPT code 69610- Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch), report only the repair code. This is because removal of the tube is part of the repair service; this is reflected in the higher value of the repair.
Reviewed August 2006
Reviewed June 2009
Workshops held in cities nationwide will help otolaryngologists, their staff, and other healthcare professionals code correctly, learn risk reduction strategies, and organize business systems.