Tympanostomy Tubes

Tympanostomy tube insertion is a surgical treatment for persistent otitis media with effusion and recurrent acute otitis media. The tubes inserted in the tympanic membrane equalize middle ear pressure with atmospheric pressure and allow fluid drainage, which alleviates symptoms of otitis media. Otitis media occurs primarily in childhood, and is rarely a work-related condition

Coverage decision: Covered with conditions (Effective date: April 1, 2016)

Authorization requirements

Is authorization required?

How do I get pre-authorization?


L&I (State fund): Complete the Preauthorization Form and fax to: 360-902-4567.

For self-insured: Contact the employer or its third party administrator.



Regulatory authority and related information

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