Otolaryngology Coding Alert

Question: When should I use new code G0268 for cerumen removal instead of 69210?

Texas Subscriber
 
Answer: You should report G0268 (Removal of impacted cerumen [one or both ears] by physician on same date of service as audiologic function testing) when cerumen removal meets three criteria. First, the otolaryngologist must perform the procedure on the same date of service as audiologic function testing. Second, the cerumen removal must be too complicated for the audiologist to perform, meaning it is truly impacted, so the otolaryngologist must perform the procedure. Third, the audio and the cerumen impaction must contain different diagnoses.
 
Code G0268 is similar to 69210 (Removal impacted cerumen [separate procedure], one or both ears) in that both codes require an otolaryngologist to remove an impaction. The two codes differ in that you should bill G0268 when your otolaryngologist performs cerumen removal prior to audiologic testing.