Item Brochure

4341 State Street Road, PO Box 220, Skaneateles Falls, NY 13153-0220 USA
(P) 800.535.6663 (F) 315.685.3361 www.welchallyn.com
© 2009 Welch Allyn SM4005 Rev A
To learn more about the Welch Allyn MicroTymp3, call your local Welch Allyn
sales representative or Welch Allyn Customer Service at 1.800.535.6663 opt 3.
Ordering Information
23650 MicroTymp3 Handle only (includes handle, battery and tip box with 2 tips of each size)
93650 MicroTymp3 Set (includes handle, battery, printer/charger, tip box with 2 tips of each size)
Replacement Tips
24620 MicroTymp3 Tip Box with (2) tips of each size
24621 MicroTymp3 Tips, (4) extra small 7 mm, black
24622 MicroTymp3 Tips, (4) small 9 mm, gray
24623 MicroTymp3 Tips, (4) medium 12 mm, blue
24624 MicroTymp3 Tips, (4) large 16 mm, green
24625 MicroTymp3 Tips, (4) extra large 20 mm, white
Technical Specifications
Probe Tone
226 Hz Amplitude: 85 ±3 dB SPL
1,000 Hz Amplitude: 83 ±3 dB SPL
Frequency Accuracy: ±2%
Total Harmonic Distortion: 3% Maximum
Signal Type: Continuous Sinusoid
All specifications measured in an ANSI HA-1 (2.0 cc) coupler.
Pressure Measurement System
Direction of sweep: positive to negative pressure
Sweep Rate: 400 daPa/sec average during data acquisition period
Range: +200 to -400 daPa
Display Resolution: 20 daPa
Accuracy: ±15% or ±10 daPa, whichever is greater
Compensation: Auto-zero every test cycle
Admittance Measurement System
226 Hz Mode:
Range: 0.2 to 4.0 mmho total
0.0 to 1.5 mmho for Ya
0.2 to 2.5 cc for +200 Vea
Accuracy: ±0.1 mmho or ±5%, whichever is greater
Positive tail compensation
1,000 Hz Mode:
Range: 0.9 to 16.6 mmho total
0.0 to 6.5 mmho for Ya*
0.2 to 2.5 cc for +200 Vea
Accuracy: ±0.4 mmho or ±5%, whichever is greater
Negative tail compensation
*for ear canal volumes ≤2.0 cc
Display Resolution:
0.1 mmho for Ya
0.2 cc for +200 Vea
Weight
Handle: 0.61 lb/0.28 kg
Printer/Charger: 3.98 lb/1.81 kg
Regulatory
The MicroTymp
®
3 complies with the following standards based
on the most recent revision available at the time of design:
UL 60601-1
CAN/CSA C22.2 No. 601.1-M90
EN/IEC 60601-1
EN/IEC 60601-1-2
ANSI S3.39 – ANSI Type 4 instrument
IEC 60645-5 – IEC Type 3 Instrument
U.S. Patent No. 5,383,097, Patent Pending
Reimbursement Information
Procedures performed with the MicroTymp3 may be eligible for Medicare
Reimbursement using CPT code 92567 Tympanometry (impedance testing).
A WORD ABOUT THE CODING INFORMATION CONTAINED IN THIS BROCHURE FROM
THE CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT
®
).
Please note that the coding information contained here is neither conclusive nor does it ensure
that you will be successful in obtaining coverage and/or reimbursement from government and
private payers.
Depending on circumstances that will vary from patient encounter to patient encounter, separate
reimbursement may or may not be allowed for use of a Welch Allyn product used during a
specific procedure or service. Use of the product may be included in the reimbursement for
Evaluation and Management services provided by the physician. Please check with the specific
payer to confirm whether or not the use of a separate code is acceptable. Welch Allyn does not
assume any responsibility for the decisions made by payers regarding payment for procedures
involving our devices when the coding information suggested in this brochure is used.
CPT is a registered trademark of the American Medical Association.
CPT Codes © 2008 American Medical Association. All rights reserved. CPT is a trademark of the
AMA. No fee schedules, basic units, relative values or related listings are included in CPT. The
AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply
to Government use.
Accessories
72910 MicroTymp3 Replacement Battery
55260 MicroTymp3 Card Holder (included in set #93650)
55270 MicroTymp3 1,000 Hz Documentation Card, 100 each
(starter pack included in sets)