CPT Code 69436 | Description, Procedure & Billing Guidelines (2022)
Report CPT 69436 for the tympanostomy that requires inserting a ventilating tube while the patient is under general anesthesia.
1. What Is CPT Code 69436?
CPT 69436 covers a tympanostomy procedure with a ventilation tube inserted while the patient is under general anesthesia.
2. Description
The CPT book defines De official description of the 69436 CPT code as: “Tympanostomy (requiring insertion of a ventilating tube), general anesthesia.”
3. Procedure
The 69436 CPT code procedure starts with prepping and draping the patient before the appropriate anesthetic agent administers general anesthesia.
Then, the provider performs a myringotomy, and a tympanostomy tube is attached to the patient’s ear drum. The tube drains out infectious fluids from the middle ear.
This procedure keeps prevents mucus in the middle ear and keeps it well-aerated.
4. How To Use CPT Code 69436
You can use CPT code 69436 for a procedure on both ears. Make sure to report this code with modifier 50 for bilateral procedures.
Do not bill CPT 99070 for the tympanostomy tube because the tube is already included in the 69436 CPT code procedure.
You may bill CPT code 69436 for tympanostomy procedures in operating rooms while the patient is under general anesthesia.
However, use CPT 69433 instead of CPT 69436 if the procedure is performed in an office with topical or local anesthesia.
Be aware that the description of CPT 69436 states ‘general anesthesia’. This is only added to the descriptor to differentiate it from tympanostomy without general anesthesia.
Therefore, anesthesia services are not included in CPT 69436. This should be billed based on when the anesthesiologist anesthetized the patient.
5. Resources
https://www.aetna.com/cpb/medical/data/400_499/0418.html
https://www.hca.wa.gov/assets/program/tympan_tubes_final_report_101615%5B1%5D_0.pdf
