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CPT for ENT: Deletion of Eustachian Tube Codes for 2015

CPT for ENT: Deletion of Eustachian Tube Codes for 2015

For CY 2015, the AMA CPT® Editorial Panel has deleted three Eustachian tube CPT codes from the CPT code set. This change was supported by the Academy, as the codes were rarely utilized and reflected outmoded codes. During a review of these codes, it became clear that there are emerging technologies related to Eustachian tube procedures, and coding for those new procedures is addressed below in a separate Q/A.

For CY 2015, the following changes will be reflected in your CPT code book:

  • 69400 Eustachian tube inflation, transnasal; with catheterization
  • (69400 has been deleted. To report, see 69799)
  • 69401 without catheterization
  • (69401 has been deleted. To report, see the appropriate Evaluation and Management code 99201 –99215)
  • 69405 Eustachian tube catheterization, transtympanic
  • (69405 has been deleted. To report, use 69799)

Q: How should I report inflation of the Eustachian tube when performed without a catheter?

A: The work of performing this maneuver is captured in the work of the E&M encounter and should be reported this work using an E/M code (99201-99215).

Q: How should I report inflation of the Eustachian tube when a catheter is utilized?

A: Report with work using the unlisted code 69799 unlisted procedure; middle ear. If performed, nasal endoscopy (CPT code 31231) or nasopharyngoscopy (CPT code 92511) should not be separately reported, as it is integral to performing the therapeutic procedure.

Q: How should I report a transtympanic catheterization of the Eustachian tube?

A: This work should also be reported using the unlisted code 69799. If performed, nasal endoscopy (CPT code 31231) or nasopharyngoscopy (CPT code 92511) should not be separately reported, as it is integral to performing the therapeutic procedure.

Q: How should I report reconstruction or modification of the Eustachian tube for treatment of patulous Eustachian tube?

A: This work should also be reported using the unlisted code 69799. If performed, nasal endoscopy (CPT code 31231) or nasopharyngoscopy (CPT code 92511) should not be separately reported, as it is integral to performing the therapeutic procedure.

Q: Now that these codes have been deleted, how should I report balloon dilation of the Eustachian tube?

A:  Category I CPT codes 69705 and 69706 are used to report nasopharyngoscopy with balloon dilation of the eustachian tube unilaterally or bilaterally, respectively.  For eustachian tube dilation via non-balloon methods, report with unlisted code 69799.

Revised October 2023

 

 

 

IMPORTANT DISCLAIMER NOTICE
CPT FOR ENT ARTICLES ARE A COLLABORATIVE EFFORT BETWEEN THE ACADEMY’S TEAM OF CPT ADVISORS, MEMBERS OF THE PHYSICIAN PAYMENT POLICY (3P) WORKGROUP, AND HEALTH POLICY STAFF. ARTICLES ARE DEVELOPED TO ADDRESS COMMON CODING QUESTIONS RECEIVED BY THE HEALTH POLICY TEAM, AS WELL AS TO CLARIFY CODING CHANGES AND CORRECT CODING PRINCIPLES FOR FREQUENTLY REPORTED ENT PROCEDURES. THESE ARTICLES ARE NOT INTENDED AS LEGAL, MEDICAL, OR BUSINESS ADVICE AND ARE NOT A GUARANTEE OF REIMBURSEMENT. THE INFORMATION IS ALSO NOT MEANT TO SERVE AS THE DEFINITIVE OR SOLE AUTHORITY ON BILLING AND CODING ISSUES. THE APPLICABILITY OF AAO-HNS BILLING AND CODING GUIDANCE FOR A PARTICULAR PROCEDURE, MUST BE DETERMINED BY THE RESPONSIBLE PHYSICIAN IN LIGHT OF ALL THE CIRCUMSTANCES PRESENTED BY THE INDIVIDUAL PATIENT. YOU SHOULD CONSULT WITH YOUR OWN ADVISORS AS WELL AS MEDICARE OR PRIVATE CARRIERS IN MAKING ANY DECISIONS ABOUT HOW TO BILL AND CODE PARTICULAR SERVICES OR PROCEDURES.
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