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2025 CPT code 69433

Tympanostomy with insertion of a ventilating tube under local or topical anesthesia.

Follow current CPT coding guidelines for ear, nose, and throat (ENT) procedures.Ensure correct modifier usage for bilateral procedures.

Modifiers 50 (bilateral procedure), 25 (significant, separately identifiable E/M service), and others as deemed clinically appropriate may be applied.

Medical necessity is established by documentation supporting the diagnosis of otitis media with effusion or other conditions requiring ventilation tube placement.The documentation should justify the need for the procedure and the chosen method of anesthesia.

The physician prepares the patient, administers local/topical anesthesia, performs the myringotomy, and inserts the tympanostomy tube. Post-operative care may be included in the global surgical package depending on payer rules.

IMPORTANT For bilateral procedures, report 69433 with modifier 50.For tympanostomy with iontophoresis and an automated tube delivery system, use 0583T.If general anesthesia is used, report 69436 instead.

In simple words: The doctor makes a tiny hole in the eardrum and puts in a small tube to drain fluid and help the ear air out.This is done with numbing medicine applied to the ear.

This procedure involves creating a small opening in the eardrum (myringotomy) and inserting a tympanostomy tube.Local or topical anesthesia is used. The tube provides continuous drainage for middle ear fluid, aeration, and prevents fluid accumulation.

Example 1: A 5-year-old patient presents with recurrent otitis media with effusion.The physician performs a tympanostomy with tube insertion under local anesthesia in the office setting., An adult patient with chronic serous otitis media undergoes a tympanostomy and tube placement under topical anesthesia during an outpatient procedure., A pediatric patient with a history of multiple ear infections requires a bilateral tympanostomy with tube insertion.The physician uses modifier 50 to indicate the bilateral nature of the procedure.

* Detailed history and physical examination documenting the indication for the procedure (e.g., recurrent otitis media with effusion, chronic serous otitis media).* Documentation of the type of anesthesia used (local or topical).* Operative report detailing the procedure performed, including the type of tube inserted.* Post-operative instructions provided to the patient.

** The supply of the tympanostomy tube is included in the procedure code and should not be billed separately.Always verify payer specific guidelines and local coverage determination.

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