Otolaryngology Coding Alert

Question: I bill 94664 with other nebulizer services (for example, 94640, A7003, J7611, and 94760), and append modifier 59 to this CPT®. So far, my claims have worked with insurance companies pretty well. However, I'm worried that I may be overusing modifier 59 because I also tend to use it on 69210 billed with an E/M code. Is my use of the modifier justified or does another modifier apply?Delaware SubscriberAnswer: First of all, don't forget that when you add modifier 59 (Distinct procedural service), you should bill the 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device) with another service. Since this seems to be what you do, it means you're on the right track. The modifier 25 is only for use with E/M services, not procedural services. On 69210 (Removal impacted cerumen [separate procedure], 1 or both ears), however, you [...]