Primary Care Coding Alert

Question: How do I code when a clinical staff member performs ear piercings?

Ann Cutler
Elkhart, Ind.

Answer: Many family practices provide the services you describe, both on adults and children.

There are two coding scenarios that might apply. If the procedure is performed at a separate visit, coders should report 69090 (ear piercing) with V50.3 (elective surgery for purposes other than remedying health states; ear piercing). If the service is provided during a scheduled visit, coders should assign 69090 and also report the appropriate level E/M service with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of other procedure or service) appended.

However, because it is an elective and non-health-related service, ear piercing will not be reimbursed. Your practice will want to collect all charges directly from the patient or family.


Answers for this issues You be the Coder and Reader Questions were provided by Tammy Chidester, CPC, billing supervisor at Upshur Medical Management Services Inc., in Buckhannon, W.Va.; Kathy Zmuda, CPC, lead inpatient coder for Cigna Health Care of Arizona in Phoenix; Sandy Page, CPC, CCS-P, co-owner, Medical Practice Support Systems Inc., a billing and coding firm in Broomfield, Colo.; and Lamon Willis, CPC, physician billing and coding healthcare consultant for St. Anthony Consulting Group in Florida.