tci ED Coding & Reimbursement Alert - 2002 Issue 6

Reader Question: Impacted Cerumen

Question: A young girl was recently brought into the ED with a high fever and difficulty breathing. The ED physician diagnosed pneumonia. During the exam, he also noted a great deal of impacted cerumen in both of the patient's ears. Should we report the cerumen removal and the ED visit code? Texas SubscriberAnswer: You should probably bill both, although that might not be true in all situations. When a patient is seen for a problem that is unrelated to the impacted earwax, many payers (including Medicare) will reimburse both services. You should report the E/M service (e.g., 99284...

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