tci ED Coding & Reimbursement Alert - 2010 Issue 11

Reader Questions: Include modifier to reflect 'partial' removals

Question: Documentation states that the physician personally removed a small portion of impacted cerumen with a curette. However, she could not remove the rest of the cerumen because it was too hard. The guideline states she should document how much time and the resources used to remove the cerumen. Should we code 69210 with modifier 52, or just roll the work into an ED E/M service?Connecticut SubscriberAnswer: Code the impacted cerumen removal (69210, Removal impacted cerumen [separate procedure], one or both ears) and consider appending the modifier 52 (Reduced services).Why not 53? Modifier 53 (Discontinued procedure) is...

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