Advanced Search

ED Coding and Reimbursement Alert

Review These Tips Before Coding For Cerumen Removal

Published on Wed Feb 26, 2014

  • Assign 69210 only when the physician extracts impacted earwax. Additionally, the new code language requires the use of instruments to remove the cerumen. Ideally the chart should specifically mention using an instrument such as forceps, suction or a right-angle hook. Remember to check your carrier’s guidelines for which removal method justifies billing 69210 (Removal of impacted cerumen requiring instrumentation, unilateral). But when the physician can easily take out the wax as part of the routine ear exam, then this small level of effort might best be rolled into the E/M code.
  • Report 69210 once per session, even if the physician removes impacted cerumen from both ears. The code’s descriptor states that 69210 covers cerumen removal “unilateral,” so modifier 50 (Bilateral procedure) would be appended.
  • Be sure you link 380.4 (Impacted cerumen) to 69210. Most payers will not accept many of the other ICD-9 codes, even if the codes describe a hearing-related problem.

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All