Otolaryngology Coding Alert
The Best Code for Conchal Bowl Erythema Treatment
Question: Our surgeon treated a patient with erythema of the conchal bowl and marked desquamated and ceruminous debris in each ear canal. The surgeon debrided the ears with operating microscope suction. The patient has retraction of pocket in her right ear. Tympanic membranes were otherwise intact and she had normal mobility on micro pneumo-otoscopy.
This patient never had bilateral mastoidectomy. Therefore, I do not believe I should bill code 69220 with modifier 50. I think codes 11000 and 92504 are more appropriate. What’s your advice?
Rhode Island Subscriber
Answer: Your best choice actually is 69210 (Removal impacted cerumen requiring instrumentation, unilateral). Note the term “ceruminous debris” in the descriptor. Code 92504 (Binocular microscopy [separate diagnostic procedure]) cannot be used in this situation because it is designated as a separate procedure. If the physician does any other procedure on the ear during the same encounter (as in this scenario), 92504 is bundled with the other procedure.
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