I'm not sure if this is something that can be billed or not- has anyone else had any experience with this? My physician did exploratory surgery and removed an old ventilation tube from the middle ear space through a tympanic membrane incision and then placed a new ventilation tube. He is wanting to either bill out for a foreign body- which the guidelines say it isn't appropriate to bill a vent tube as a foreign body or he wants to bill an unlisted procedure since he removed the old tube from the ear space itself... I know that tube removal is included with the insertion of a new tube... any thoughts?
Here is the OP note:
Myringotomy and exploration of right middle ear with removal of foreign body/old vent tube from middle ear, placement of vent tube in right tympanic membrane
...An incision was made in the posterior inferior portion of the tympanic membrane where the foreign body was last seen. A large amount of fluid was aspirated. The edge of an old blue Paparella Type 2 vent tube was removed with alligator forceps with teeth used to grasp the old tube and removed from the middle ear space. Additional suction was used to remove any remaining fluid. A Rube vent tube was placed through the myringotomy site and appropriately placed. Additional suction was applied to remove any residual fluid. Ofloxacin drops were placed and procedure was terminated...
I only billed 69436... Thoughts?
Here is the OP note:
Myringotomy and exploration of right middle ear with removal of foreign body/old vent tube from middle ear, placement of vent tube in right tympanic membrane
...An incision was made in the posterior inferior portion of the tympanic membrane where the foreign body was last seen. A large amount of fluid was aspirated. The edge of an old blue Paparella Type 2 vent tube was removed with alligator forceps with teeth used to grasp the old tube and removed from the middle ear space. Additional suction was used to remove any remaining fluid. A Rube vent tube was placed through the myringotomy site and appropriately placed. Additional suction was applied to remove any residual fluid. Ofloxacin drops were placed and procedure was terminated...
I only billed 69436... Thoughts?