Primary Care Coding Alert

Question: One of our physicians inserted an ear wick saturated with an antibiotic into an established patient's ear to reach an infection in the right inner ear. How should I report the procedure?


Oklahoma Subscriber

Answer: When your physician has to insert and/or remove an ear wick, there is no code to represent the specific procedure. The ear wick insertion is bundled into whatever code you report for the encounter.

When the physician performs only the insertion but no other procedure, the payer considers the ear wick insertion part of the E/M service.

Suppose the procedure notes indicate a level-two E/M service. On the claim, you would:

- report 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a problem-focused history; a problem-focused examination; and straightforward medical decision- making) for the E/M.

- attach 386.30 (Labyrinthitis, unspecified) to 99212 to provide medical necessity for the E/M service.

The family physician may also perform ear wick insertion while performing an ear drainage (for example, 69000, Drainage external ear, abscess or hematoma; simple; or 69020, Drainage external auditory canal, abscess). In these scenarios, the wick insertion is bundled into the drainage code.