Tympanostomy Tube with Intratympanic Injection

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April 28, 2016

Question:
I did an intratympanic steroid injection and coded 69801 and 69433. Medicare paid 69801. Should I appeal the denial of 69433?

Answer:
No! CPT 69801 says Labyrinthotomy, with perfusion of vestibuloactive drug(s); transcanal. The CPT guidelines say: Do not report 69801 in conjunction with 69420, 69421, 69433, 69436 when performed on the same ear. By billing 69801 and 69433, for procedures on the same ear, you’ve unbundled the codes. The denial is accurate so you should not appeal. Furthermore, in the future, do not bill 69433 or 69436 (tympanostomy tube placement) or 69420 or 69421 (myringotomy) for the same ear when you also report 69801.

*This response is based on the best information available as of 04/28/16.