Primary Care Coding Alert

Report 69200/69205 for ear procedures.

Coders will often face encounter forms that involve a foreign body removal (FBR).

Providers that perform foreign body removals (FBRs) need to have coders that know you cannot report the standard FBR codes — 10120 (Incision and removal of foreign body, subcutaneous tissues; simple) or 10121 (… complicated) — for ear FBRs.

The key to mastery when coding these claims comes from knowledge of each type of ear procedure your provider might perform.

Here’s a look at how to code some FBRs you won’t find in the patient’s subcutaneous tissue.

Consider These Ear FBR Definitions

CPT^® contains a code pair for external auditory canal FBRs: 69200 (Removal foreign body from external auditory canal; without general anesthesia) and 69205 (… with general anesthesia) — though FP’s rarely perform 69205 services.

What qualifies as an ear FB? Just about anything that’s not supposed to be there. “Anything other than normal parts or secretions of the ear are considered foreign bodies,” explains Beth Adams, billing manager at Advocare ENT Specialty Center in Marlton, N.J. “The foreign body does not have to be a certain size or depth.”

FB examples:  “Hearing aid piece, bugs, beads, food, cotton, pencil erasers, buttons, beans, etc.,” says Lisa Jones, CPC, consultant at 360 Practice Management Solutions in Hollywood, Fla.

Non-FBs: “Skin debris, cerumen, cholesteatomas, abscesses, etc., are not foreign bodies,” Jones continues.

Also, keep in mind that something the physician places in the patient’s ear, such as a tube, does not qualify as an FB.

Clues: During a 69200 service, the provider would likely use a combination of the following instruments and supplies, Adams says: hook, curette, cerumen loop, forceps, right-angle ball hook, or suction.

Bug in your ear? Jones says that when a person has a living ear FB, such as a bug, the provider might need to use oil drops to immobilize it before removal.