tci ED Coding & Reimbursement Alert - 2005 Issue 3

READER QUESTIONS: Use 69210 Only for Stubborn Wax

Question: The physician documented that a patient has "wax bilaterally" and that he removed the wax by "flushing ears bilaterally." Can we report 69210 in addition to an E/M?North Carolina Subscriber Answer: You should use 69210 (Removal impacted cerumen [separate procedure], one or both ears) only when the physician removes "impacted" cerumen, not simple earwax blockage. For instance, if your physician used irrigation, Cerumenex, or forceps to remove impacted cerumen, you should assign 69210. Also, you should link 380.4 (Impacted cerumen) to 69210 to show medical necessity. Note: Payers vary on their guidelines regarding acceptable...

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