Pediatric Coding Alert

Question: Our pediatrician saw a little boy with what she called retained tympanostomy tubes. The tubes had worked their way out of the drum and were in the ear canals. She was able to remove one by irrigation but not the other.

I was unsure how to diagnose this so I contacted our local ENT office. Their coder said she would use 381.10, as this is why the tubes were placed, and then V80.3. I am unsure these are the best codes to use; do you have any suggestions?

Nebraska Subscriber

Answer: The ENT coder is partially correct. For tube removal, whether accidental or intentional, you should use the reason the tubes were originally placed, such as chronic serous otitis media (381.10). Theres no reason to add the screening code (V80.3, Special screening for neurological, eye, and ear diseases; ear diseases).

A common mistake is to treat the tubes as foreign bodies (931, Foreign body in ear). A medical device, however, is not considered a foreign body.