ETD Device // CPT 69401 // Earpopper / OtoVent

[Guest guest]

Clinical - are patients happy with this? Wouldn't teaching val-salva maneuver work the same? See below for EarPopper and OtoVent devices.Practice Management -- anyone doing this in-office and getting paid?

CPT 69401 seems to apply to this procedure.Seems to pay a lot more than I expected.One of my private insurances says - 69401 $120.81Medicare says...~$83 in Colorado.Would seem to cover the cost of the EarPopper device (~$300) and the disposable tips (~$3/tip) - after 4-6 treatments.

Or the Otovent - which the company said is about $140 for the 12 person kit - ~$12/device.

CPT

Description

69401

Inflate middle ear canal

HCPCS CODE

MODIFIER

PROC STAT

CARRIER LOCALITY

NON-FACILITY PRICE

FACILITY PRICE

NON-FACILITY LIMITING CHARGE

FACILITY LIMITING CHARGE

CONV FACT

NA FLAG FOR TRANS NON-FAC PE RVU

NA FLG FOR FULLY IMP NON-FAC PE RVU

NA FLAG FOR TRANS FACILITY PE RVU

NA FLAG FOR FULLY IMP FAC PE RVU

NOT USED FOR MEDICARE

OPPS NON-FACILITY PAYMENT AMOUNT1

OPPS FACILITY PAYMENT AMOUNT1

69401

 

A

0410201

$83.83

$48.94

$91.59

$53.47

33.9764

 

 

 

 

 

NA

NABTW, no financial ties to the devices.Any other devices that you know about?Would seem that Val-Salva would work just as well...yes?

http://www.invotec.net/otovent.html

Otovent® Auto Middle Ear Inflation System

» Ordering Information

» Clinical

The proven alternative to the surgical treatment of symptoms of Otitis Media and Eustachian Tube Dysfunction.

The Valsalva and Politzer treatments have long been used to equalize middle ear pressure in the presence of negative pressure pain of Otitis Media, Barotrauma due to underwater pressure, air flight, or hyperbaric chamber treatments.

Used around the world, for more than fifteen years, the Otovent Middle Ear Auto Inflation System offers Otitis Media Patients, and those suffering from Barotrauma a proven protocol to equalize middle ear pressure.

The system consists of a nares bulb and an ample supply of latex balloons to perform safe and effective middle ear auto inflation, 2-3 times daily, for up to 4 weeks.

It’s simple. With one nostril pinched shut, and the balloon mounted nose plug held against the other nostrum, the patient inflates the balloon. Once fully extended, the patient then allows the positive pressure of the balloon to reenter the nose, and swallows, achieving trans-Eustachian tube middle ear insufflation. 

Otovent Treatment SetEach Kit Contains: One nose piece made of PVC, One instruction leaflet, and

10 pressure tested latex balloons.

Catalog No.DescriptionQty/Box90-00000Otovent Kits, 1 Case12 patient kits

90-00001Otovent Kits, 1/2 Case6 patient kits90-00000BOtovent balloons5 per pack

 To order products, for more information or if you have any questions, please feel free to contact us at .

=======================

http://www.bcm.edu/oto/index.cfm?pmid=15420Self-Inflation of the Ears: It is possible to forcibly blow air through the Eustachian tube into the middle ear by pinching the nose closed and “popping the ear.” Another way to do this is to blow up balloons. The pressure required to expand a balloon is usually enough to push air up the Eustachian tube. This is a very useful maneuver and may be repeated as often as necessary, whenever a sense of pressure or fullness in the ear develops. This should not be performed when a cold or nasal discharge is present as this may drive infected mucous into the middle ear and cause an ear infection.

=======================================

http://www.earpopper.com/physician/documents/EfficacyofaModifiedPolitzerApparatusinMgmtofEustachianTubeDysfunctioninAdults.pdf

J Am Acad Audiol. 1999 Oct;10(9):496-501.

Efficacy of a modified politzer apparatus in management of eustachian tube dysfunction in adults.Silman S, Arick D.

Department of Speech Communication Arts and Sciences, Brooklyn College, City University of New York, 11210, USA.

AbstractThis study evaluates the efficacy of politzeration on eustachian tube dysfunction following airplane travel using an automated, hand-held device that controls the volume velocity of air flow. Fourteen adults with eustachian tube dysfunction following airplane travel comprised the experimental group. They received politzeration over a period of 6 weeks on a twice-a-week basis. Fourteen adults with eustachian tube dysfunction following airplane travel comprised the control group. They were untreated. Complete audiologic and otolaryngologic evaluations were performed at the pretest and after politzeration treatment was completed. The results revealed a substantial, significant improvement in the mean tympanometric peak pressure from pretest to final post-treatment retest in the experimental, but not the control, subjects. The mean air-bone gap increased significantly from pretest to final post-treatment retest in the control, but not the experimental, subjects. 

Of the experimental subjects with abnormal tympanometric peak pressures at the pretest, resolution to within normal limits occurred in 71 percent of the experimental subjects versus 21 percent of the control subjects. These results suggest the potential feasibility of treatment of aerotitis media in adults with this modified Politzer method using the automated apparatus.

Locke, MD

[Guest guest]

,I got my EarPopper device in 2006 because it seemed like it had a good return of investment. I don't use it frequently (about 5 times a year) but the reimbursement is such that it paid for itself after a 4-5 treatments. Anthem BC pays about $70 while Blue Shield pays about $85 for 69401. I wouldn't mind doing this more often since it pays pretty well.I have only found it to be successful about 50% of the time, unfortunately. When it works, the results can be quite dramatic. I notice that the study you attached on politzeration states that they treated people twice a week for 6 weeks to achieve their 71 percent success rate. I bet I could achieve that level of success, too, or better if I could treat people twice a week, but I have never treated anyone beyond one visit. In my experience, the Valsalva maneuver can work but usually just temporarily relieves the blockage and it plugs up again. Plus, a lot of the time, I would worry about blowing infection into the eustachian tubes since a lot of the time these particular patients have a URI. SetoSouth Pasadena

Clinical - are patients happy with this? Wouldn't teaching val-salva maneuver work the same? See below for EarPopper and OtoVent devices.Practice Management -- anyone doing this in-office and getting paid?

CPT 69401 seems to apply to this procedure.Seems to pay a lot more than I expected.One of my private insurances says - 69401 $120.81Medicare says...~$83 in Colorado.Would seem to cover the cost of the EarPopper device (~$300) and the disposable tips (~$3/tip) - after 4-6 treatments.

Or the Otovent - which the company said is about $140 for the 12 person kit - ~$12/device.

CPT

Description

69401

Inflate middle ear canal

HCPCS CODE

MODIFIER

PROC STAT

CARRIER LOCALITY

NON-FACILITY PRICE

FACILITY PRICE

NON-FACILITY LIMITING CHARGE

FACILITY LIMITING CHARGE

CONV FACT

NA FLAG FOR TRANS NON-FAC PE RVU

NA FLG FOR FULLY IMP NON-FAC PE RVU

NA FLAG FOR TRANS FACILITY PE RVU

NA FLAG FOR FULLY IMP FAC PE RVU

NOT USED FOR MEDICARE

OPPS NON-FACILITY PAYMENT AMOUNT1

OPPS FACILITY PAYMENT AMOUNT1

69401

A

0410201

$83.83

$48.94

$91.59

$53.47

33.9764

NA

NABTW, no financial ties to the devices.Any other devices that you know about?Would seem that Val-Salva would work just as well...yes?

http://www.invotec.net/otovent.html

Otovent® Auto Middle Ear Inflation System» Ordering Information

» Clinical

The proven alternative to the surgical treatment of symptoms of Otitis Media and Eustachian Tube Dysfunction.

The Valsalva and Politzer treatments have long been used to equalize middle ear pressure in the presence of negative pressure pain of Otitis Media, Barotrauma due to underwater pressure, air flight, or hyperbaric chamber treatments.Used around the world, for more than fifteen years, the Otovent Middle Ear Auto Inflation System offers Otitis Media Patients, and those suffering from Barotrauma a proven protocol to equalize middle ear pressure.The system consists of a nares bulb and an ample supply of latex balloons to perform safe and effective middle ear auto inflation, 2-3 times daily, for up to 4 weeks.It’s simple. With one nostril pinched shut, and the balloon mounted nose plug held against the other nostrum, the patient inflates the balloon. Once fully extended, the patient then allows the positive pressure of the balloon to reenter the nose, and swallows, achieving trans-Eustachian tube middle ear insufflation.

Otovent Treatment SetEach Kit Contains: One nose piece made of PVC, One instruction leaflet, and

10 pressure tested latex balloons.

Catalog No.DescriptionQty/Box90-00000Otovent Kits, 1 Case12 patient kits

90-00001Otovent Kits, 1/2 Case6 patient kits90-00000BOtovent balloons5 per pack

To order products, for more information or if you have any questions, please feel free to contact us at .

=======================

http://www.bcm.edu/oto/index.cfm?pmid=15420Self-Inflation of the Ears: It is possible to forcibly blow air through the Eustachian tube into the middle ear by pinching the nose closed and “popping the ear.” Another way to do this is to blow up balloons. The pressure required to expand a balloon is usually enough to push air up the Eustachian tube. This is a very useful maneuver and may be repeated as often as necessary, whenever a sense of pressure or fullness in the ear develops. This should not be performed when a cold or nasal discharge is present as this may drive infected mucous into the middle ear and cause an ear infection.

=======================================

http://www.earpopper.com/physician/documents/EfficacyofaModifiedPolitzerApparatusinMgmtofEustachianTubeDysfunctioninAdults.pdf

J Am Acad Audiol. 1999 Oct;10(9):496-501.

Efficacy of a modified politzer apparatus in management of eustachian tube dysfunction in adults.Silman S, Arick D.Department of Speech Communication Arts and Sciences, Brooklyn College, City University of New York, 11210, USA.

AbstractThis study evaluates the efficacy of politzeration on eustachian tube dysfunction following airplane travel using an automated, hand-held device that controls the volume velocity of air flow. Fourteen adults with eustachian tube dysfunction following airplane travel comprised the experimental group. They received politzeration over a period of 6 weeks on a twice-a-week basis. Fourteen adults with eustachian tube dysfunction following airplane travel comprised the control group. They were untreated. Complete audiologic and otolaryngologic evaluations were performed at the pretest and after politzeration treatment was completed. The results revealed a substantial, significant improvement in the mean tympanometric peak pressure from pretest to final post-treatment retest in the experimental, but not the control, subjects. The mean air-bone gap increased significantly from pretest to final post-treatment retest in the control, but not the experimental, subjects. Of the experimental subjects with abnormal tympanometric peak pressures at the pretest, resolution to within normal limits occurred in 71 percent of the experimental subjects versus 21 percent of the control subjects. These results suggest the potential feasibility of treatment of aerotitis media in adults with this modified Politzer method using the automated apparatus. Locke, MD