Coding the Microscope with Tympanostomy Tube Placement

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September 20, 2018

Question:
My doctor wants me to bill +69990 (use of the operating microscope) with 69436 when she uses the microscope in the operating room to place tympanostomy tubes. What do you think?

Answer:
We do not advocate this practice.  Why? Because the microscope is not being used for microdissection or microsurgery as the code states.  Rather, it is being used for magnification and illumination during tympanostomy tube placement.  A CPT Assistant from February 2018 actually supports this advice we’ve been giving for years.

*This response is based on the best information available as of 09/20/18.

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