Otolaryngology Coding Alert

Question: An otolaryngologist removes a bead from each of a child's ears under anesthesia. Should I bill for the second ear with modifier -50?

New Jersey Subscriber

Answer: Code 69205 (Removal foreign body from external auditory canal; with general anesthesia) stipulates "foreign body" singular, not plural. Therefore, you should report each removal. In addition, the code for foreign-body removal from ear is a unilateral code, so you need to bill for the removals per ear.
 
To indicate a separate site (left ear from right ear), append modifier -59 (Distinct procedural service) to the second ear procedure instead of modifier -50 (Bilateral procedure). For payers that accept body modifiers, you  should also append modifier -LT (Left side) and -RT (Right side) to 69205 to identify the specific ear. For removing one bead from the right ear and one bead from the left ear, you might bill: