CPT for ENT: Tympanostomy (PE Tube Removal)

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. One may report 92504 if in-office microscopy is used to perform the tube 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.

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.