How To Use CPT Code 69433

CPT 69433 describes the procedure of tympanostomy, which involves the insertion of a ventilating tube into the eardrum under local or topical anesthesia. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 69433?

CPT 69433 is used to report the insertion of a ventilating tube into the eardrum, a procedure known as tympanostomy. This procedure is performed by a healthcare provider under local or topical anesthesia. It involves making a small opening in the eardrum (myringotomy) and securing a delicate tympanostomy tube to allow for continuous drainage of infectious fluid in the middle ear and to maintain proper aeration while preventing fluid accumulation.

2. Official Description

The official description of CPT code 69433 is: ‘Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia.’

3. Procedure

1. The patient is prepared and draped in a sterile manner.
2. Local anesthesia is induced using an appropriate topical anesthetic agent.
3. A small opening is made in the eardrum (myringotomy).
4. A delicate tympanostomy tube is inserted and secured in the eardrum to facilitate continuous drainage of infectious fluid and maintain proper aeration.

4. Qualifying circumstances

CPT 69433 is performed on patients who require tympanostomy with the insertion of a ventilating tube. It is typically indicated for conditions such as chronic ear infections or fluid accumulation in the middle ear. The procedure is performed by a healthcare provider under local or topical anesthesia.

5. When to use CPT code 69433

CPT code 69433 should be used when a healthcare provider performs tympanostomy with the insertion of a ventilating tube under local or topical anesthesia. It is important to note that this code should not be used for procedures performed in an operating room using general anesthesia, as a different code (69436) should be reported in such cases.

6. Documentation requirements

To support a claim for CPT 69433, the healthcare provider must document the following information:

• Patient’s diagnosis necessitating tympanostomy
• Use of local or topical anesthesia
• Date of the procedure
• Details of the procedure, including the myringotomy and insertion of the ventilating tube
• Any additional relevant information or complications

7. Billing guidelines

When billing for CPT 69433, ensure that the procedure is performed under local or topical anesthesia. It is important to note that the supply of the ventilating tube is included with the procedure, so there is no need to report it separately. Additionally, do not report CPT 99070 for the tympanostomy tube itself.

8. Historical information

CPT 69433 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 pediatrician performing tympanostomy with the insertion of a ventilating tube under local anesthesia for a child with recurrent ear infections.
2. An otolaryngologist performing tympanostomy with the insertion of a ventilating tube under topical anesthesia for a patient with chronic fluid accumulation in the middle ear.
3. A family physician performing tympanostomy with the insertion of a ventilating tube under local anesthesia for an adult with persistent ear pain.
4. An ENT specialist performing tympanostomy with the insertion of a ventilating tube under topical anesthesia for a patient with eustachian tube dysfunction.
5. A pediatric otolaryngologist performing tympanostomy with the insertion of a ventilating tube under local anesthesia for a child with hearing loss due to chronic middle ear fluid.