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 because the modifier 50 (Bilateral procedure) is not applicable to 69205 in the fee schedule. You may also want to append modifier LT (Left side) and RT (Right side) to 69205 to identify the specific ear for clarity on the claim. For removing one bead from the right ear and one bead from the left ear, you might bill:

• 69205-RT
• 69205-59-LT.