Otolaryngology Coding Alert

Question: I was told that when 69210 became bilateral, G0268 was no longer in use. Someone else told me we can still use the G code when audiograms are performed. Who’s right? 

Louisiana Subscriber

Answer: Code G0268 (Removal of impacted cerumen [one or both ears] by physician on same date of service as audiologic function testing) still exists for government plans. They created it so that they knew that a physician was removing the cerumen on the same date as audiology services for a Medicare or Medicaid managed care patient. Modifier 50 (Bilateral procedure) is not a factor because Medicare won’t allow providers to bill cerumen removal as bilateral. 

Report 69210 (Removal impacted cerumen requiring instrumentation, unilateral) to private payers for the service. Some have taken the same stance as Medicare and don’t allow bilateral reporting, but others might let you report either modifier 50 or LT (Left side) or RT (Right side). Be sure to check the payer’s policy so you’ll submit the claim correctly.