Anesthesia Coding Alert

Question: The anesthesiologist provided service during a tympanostomy of the left ear on an 11-month-old child. One of my textbooks states to report 00126, but I question that because the descriptor specifies tympanotomy. What's the correct anesthesia code?

Answer: Your textbook is correct in recommending 00126 (Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy) for the procedure described.

Explanation: You can find information to support reporting 00126 in two places. First, the surgical code 69433 (Tympanostomy [requiring insertion of ventilating tube], local or topical anesthesia) crosswalks to 00126. Second, check your copy of the Relative Value Guide from the American Society of Anesthesiologists. A comment with 00126 notes that the code includes tympanostomy.

Bonus code: The patient's age meets criteria for qualifying circumstances during anesthesia administration. Include +99100 (Anesthesia for patient of extreme age, younger than 1 year and older than 70 [List separately in addition to code for primary anesthesia procedure]). Not all payers reimburse for qualifying circumstances codes, but you can always report the service to keep your claim accurate.