How To Use CPT Code 69420

CPT 69420 describes the procedure of myringotomy, which involves making a small incision in the eardrum to treat auditory tube dysfunction or otitis media. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 69420?

CPT 69420 is used to describe the procedure of myringotomy, which involves making a small incision in the eardrum to treat auditory tube dysfunction or otitis media. This code is used when the provider performs the procedure under local or topical anesthesia. It may also involve the aspiration of fluid from the middle ear and the inflation of the eustachian tube.

2. Official Description

The official description of CPT code 69420 is: ‘Myringotomy including aspiration and/or eustachian tube inflation.’

3. Procedure

1. The provider prepares the patient and administers topical anesthesia.
2. A small incision is made in the eardrum (myringotomy).
3. The provider may aspirate fluid from the middle ear if present.
4. A tube or catheter is inserted through the incision to inflate the eustachian tube.
5. The procedure is performed to treat auditory tube dysfunction or otitis media.

4. Qualifying circumstances

CPT 69420 is performed on patients with auditory tube dysfunction or otitis media. The procedure is typically done under local or topical anesthesia. It is important to note that this code is not used when the procedure is performed under general anesthesia.

5. When to use CPT code 69420

CPT code 69420 should be used when the provider performs a myringotomy procedure under local or topical anesthesia. It is important to use this code only when the procedure is performed with the patient awake and not under general anesthesia.

6. Documentation requirements

To support a claim for CPT 69420, the provider must document the following information:

• Patient’s diagnosis of auditory tube dysfunction or otitis media
• Use of topical anesthesia
• Date and time of the procedure
• Details of the procedure, including the incision, aspiration, and eustachian tube inflation
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 69420, ensure that the procedure is performed under local or topical anesthesia. If the procedure is performed under general anesthesia, a different code should be used. It is important to note that CPT 69420 may not be accepted by all payers, especially for certain types of myringotomy procedures. It is recommended to review payer guidelines and policies before submitting a claim.

8. Historical information

CPT 69420 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a myringotomy procedure on a patient with auditory tube dysfunction under topical anesthesia.
2. A child with recurrent otitis media undergoes a myringotomy procedure with eustachian tube inflation under local anesthesia.
3. A patient with chronic ear infections receives a myringotomy procedure with fluid aspiration and eustachian tube inflation under topical anesthesia.
4. A provider performs a myringotomy procedure on an adult with persistent auditory tube dysfunction under local anesthesia.
5. A myringotomy procedure is performed on a patient with acute otitis media under topical anesthesia.
6. A child with chronic fluid buildup in the middle ear undergoes a myringotomy procedure with eustachian tube inflation under local anesthesia.
7. A provider performs a myringotomy procedure on a patient with recurrent ear infections under topical anesthesia.
8. An adult with eustachian tube dysfunction receives a myringotomy procedure with fluid aspiration under local anesthesia.
9. A myringotomy procedure is performed on a patient with chronic otitis media under topical anesthesia.
10. A child with persistent fluid in the middle ear undergoes a myringotomy procedure with eustachian tube inflation under local anesthesia.