tci ED Coding & Reimbursement Alert - 2004 Issue 5

Reader Question: How to Report Cerumen Removal

Question: How should I report cerumen removal, and can I ever report a separate evaluation and management service as well for a Medicare patient?Ohio Subscriber Answer: You should report cerumen removal with 69210 (Removal impacted cerumen [separate procedure], one or both ears). You can code a separate E/M service when reporting to Medicare only if the patient receives a significant, separately identifiable service. Keep in mind that the encounter must meet four  conditions to earn reimbursement:presence of impacted cerumen;a medically necessary removal;cerumen removal performed by the physician or a nonphysician practitioner; andsignificant effort required for removal...

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