2025 CPT code 69436

Tympanostomy with insertion of a ventilating tube, performed under general anesthesia.

Consult the AMA CPT manual for detailed coding guidelines and potential modifiers applicable to this procedure.Always adhere to payer-specific guidelines and local coverage determinations.

Modifier 50 (Bilateral Procedure) can be used if the procedure is performed on both ears during the same operative session.Other modifiers may apply depending on specific circumstances (e.g., anesthesia services, assistant surgeon).

Medical necessity for tympanostomy with tube placement is typically established based on persistent middle ear effusion, recurrent acute otitis media, and significant hearing impairment despite conservative management (e.g., antibiotics, decongestants).Documentation should support the diagnosis and justify the need for surgery.

The physician performs the tympanostomy and tube insertion under general anesthesia.Preoperative preparation, draping, myringotomy, and securing the tube are all part of the physician's responsibility. Anesthesiologist provides and bills for the anesthesia separately.

IMPORTANT For office-based tympanostomy using local or topical anesthesia, use code 69433.Code 69436 does not include anesthesia services; the anesthesiologist bills separately. Do not report 99070 for the tube itself, as it's included in the procedure.

In simple words: This is an ear surgery where a small tube is placed in the eardrum to drain fluid and improve hearing.The surgery is done while the patient is under general anesthesia (completely asleep).

This procedure involves a tympanostomy, which requires the insertion of a ventilation tube into the eardrum under general anesthesia.The patient undergoes preparation and draping in a sterile manner. General anesthesia is administered using an appropriate anesthetic agent. A myringotomy is performed, and a tympanostomy tube is carefully secured into the eardrum to provide continuous drainage of middle ear fluid, maintain middle ear aeration, and prevent mucus accumulation.

Example 1: A 5-year-old child presents with recurrent otitis media with effusion (fluid in the middle ear).The physician recommends a tympanostomy with tube placement under general anesthesia to facilitate drainage and prevent further hearing loss., An adult patient with chronic otitis media and significant hearing impairment undergoes a tympanostomy and tube insertion under general anesthesia to improve ventilation of the middle ear and alleviate symptoms., A patient with a history of multiple ear infections and persistent fluid buildup in the middle ear is scheduled for a tympanostomy with tube insertion under general anesthesia to resolve the infection and improve hearing.

Complete medical history, physical examination findings, audiometric testing results, pre-operative and postoperative assessments, operative report detailing the procedure performed (including type of tube used), and any relevant imaging studies (if performed).

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