# Cerumen Removal - Does a physician have to remov



## harlisgrandma@hotmail.com (Feb 11, 2016)

Does a physician have to remove cerumen to bill 69210 or 69209 or can a nurse remove it and still bill? Has anyone billed the 69209 and what is the reimbursement for it?


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## ehanna (Feb 11, 2016)

harlisgrandma@hotmail.com said:


> Does a physician have to remove cerumen to bill 69210 or 69209 or can a nurse remove it and still bill? Has anyone billed the 69209 and what is the reimbursement for it?



69210 requires the doctor perform the procedure and document instrumentation with diagnosis of cerumen impaction. 69209 can be done by the MA/Nurse as long as there is a cerumen impaction documented. this can be done by irrigation only.  

I hope this helps


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## scarrel (Mar 14, 2016)

Does there have to be an order from the provider before the MA can perform this procedure?  Is an e/m code able to be billed on the same day?  For instance, if patient sees the doctor for ear pain and then the MA does the removal of impacted cerumen, can we bill both the appropriate e/m code and 69209?  What if patient sees the doctor for something unrelated, can 69209 be billed too?


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## ehanna (Mar 15, 2016)

scarrel said:


> Does there have to be an order from the provider before the MA can perform this procedure?  Is an e/m code able to be billed on the same day?  For instance, if patient sees the doctor for ear pain and then the MA does the removal of impacted cerumen, can we bill both the appropriate e/m code and 69209?  What if patient sees the doctor for something unrelated, can 69209 be billed too?



You can bill the 69209, along with the E&M, as long as the record supports the cerumen impaction. -25 modifier on the level.

I hope this helps


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## lesia0131 (Mar 23, 2016)

can you bill the 69210 for each ear or is it only billed once for both ears


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## ehanna (Mar 23, 2016)

lesia0131 said:


> can you bill the 69210 for each ear or is it only billed once for both ears



If you read your CPT you will see 69210 is a unilateral code. Report modifier -50 if bilateral. There is a lot of good information in your CPT!!


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## valleycoder (Mar 29, 2016)

Medicare will not reimburse for bilateral so using modifier -50 depends on the payer.


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