Pediatric Coding Alert

Reader Question:

Checking Tubes

Question: How should we code for looking at tubes when the child has no symptoms?

Michigan Subscriber
Answer: Normally, the ENT does this as part of his or her global fee for the surgery. If the primary-care pediatrician must look at the tubes, it's usually because the child has some symptom such as painful or itchy ears.
 
If you see the child just to look at the ears, your only option is to use the standard office visit codes, 99201-99205, new patient, or 99211-99215, established patient.
 
  Clinical and coding advice for Reader Questions and You Be the Coder provided by Richard H. Tuck, MD, FAAP, founding chairman, AAP coding and reimbursement committee; and A.D. Jacobson, MD, FAAP, chairman, AAP section on administration and practice management.
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