tci Part B Insider - 2012 Issue 5

Reader Question: 69210: Know the Definition of 'Impacted'

Question: When we report 69210 (Removal impacted cerumen [separate procedure], 1 or both ears) with an office visit, we typically append modifier 25 to the E/M service but the cerumen removal is being denied. Should we instead be putting the modifier on 69210?Answer: It sounds like you coded correctly if your physician documented properly, but you must first check the record to ensure that you were justified in billing both services together.Your first step is to determine how the physician removed the cerumen, and if it was indeed impacted. If the doctor merely performed an ear wash...

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