Primary Care Coding Alert

Reader Question:

Don't Expect to Collect for Ear Piercings

Question: Which code should I report when a clinical staff member performs ear piercings?

Illinois Subscriber

Answer: Two coding scenarios might apply. If the clinician performs the procedure as a standalone service, coders should report 69090 (Ear piercing) with V50.3 (Elective surgery for purposes other than remedying health states; ear piercing).

If your staff member performs the ear piercing during a scheduled visit, coders should assign 69090 and also report the appropriate-level E/M service (99211-99215 for established outpatients) with modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the other procedure or service) appended.

Remember, however, that because ear piercing is an elective and non-health-related service, payers will not reimburse you for it. You should collect all charges directly from the patient or family.

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