tracheostomy tube changes

How would you code a trach tube change under anesthesia for a hospital out patient? In the office it is an E&M.

re: tracheostomy tube changes

Use the unlisted code 31899; make sure the surgeon thoroughly documents the medical necessity in the operative report and lists the extenuating circumstances such as mental incapacity, uncooperative, physical limitations, or any other barriers to doing a trach change in the office.