tci Outpatient Facility Coding Alert - 2014 Issue 5

Reader question: Follow Your Physician Note to Code Cerumen Removal

Question: How to we bill an impacted cerumen removal with general check-up at our outpatient clinic? Should we append a modifier? Texas Subscriber Answer: Follow the physician’s note as your guide. If the physician is only doing an ear wash, you cannot bill 69210 (Removal impacted cerumen requiring instrumentation, unilateral). Ear wash neither needs specialized skill nor use of specialized instruments like curretes. In this case you need to include the service in the E/M care (99201-99215, Office or other outpatient visit ...). You would code 69210, however, when the provider uses an instrument such as a curette...

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