Otolaryngology Coding Alert

Question: When my otolaryngologist performs ear debridements in the office to remove wax, should I also report the operating microscope code (69990)?

New Jersey Subscriber

Answer: No, you should use +69990 (Microsurgical techniques, requiring use of operating microscope [list separately in addition to code for primary procedure]) only when your otolaryngologist performs microsurgical techniques requiring the operating microscope, which is too large for the office. When your otolaryngologist uses a microscope in the office to look into a patient's ear prior to removing impacted cerumen (69210, Removal impacted cerumen [separate procedure], one or both ears), he uses a binocular microscope (92504, Binocular microscopy [separate diagnostic procedure]), not an operating microscope.
 
Don't report 92504 in addition to 69210. Due to 92504's "separate procedure" descriptor, you should separately report this code only when your otolaryngologist performs no other procedure on the ears at the same session or provides an unrelated E/M service (such as 99212-99215, Office or other outpatient visit for the evaluation and management of an established patient).