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My physician has placed a ventilation tube in an eardrum where he did not preform a myringotomy because the eardrum already had an existing hole. How would we code this situation.
You would still use 69433 (local/topical anesthesia) or 69436 (under general anesthesia), even though a myringotomy is not performed.
What you are describing is similar to removing the ear tube and putting in a new ear tube through the existing hole in the tympanic membrane. In this case a myringotomy is not performed either nor can you bill for the ear tube removal; only 69433 or 69436 is billed.