Here's Why You Can't Submit 92504 with 69210
Question: I recently attended a course where the instructor said we could bill 92504 for binocular microscopy with 69210. I’ve tried it a few times since then but the payer always bundles 92504 into the 69210. If it’s really billable, how should I approach an appeal? Minnesota Subscriber Answer: Current CCI (Correct Coding Initiative) edits list 92504 (Binocular microscopy [separate diagnostic procedure]) as a Column 2 code of 69210 (Removal impacted cerumen requiring instrumentation, unilateral). You cannot report the procedures together under any circumstances, if you’re submitting the claim to a payer that follows CCI. Another detail: Also note that the descriptor states that 92504 is a separate diagnostic procedure, meaning you don’t report it with other procedures in the same anatomic area. Your provider would need to use the microscope to study one area and complete a procedure affecting another anatomic area before you could submit both codes (with clear documentation that the services were separate).
