Hello,
I work at a Pediatric Clinic in MS. We have a claim where we are billing for the ear wash 69209 (for impacted cerumen removal) while being done during a well visit (99393). We have the appropriate modifiers attached to the codes but Magnolia MSCAN denied 69209 as "x9 Procedure Codes Pair Incidental, Mutually exclusive or unbundled." Can the cpt code 69209 not be billed along with a wellness exam?
We coded the claim as follows:
99393,EP
69209,RT
3008F
99173,EP
92551,EP
note: all other codes have paid as allowed except the 69209
I have found articles from AAPC, AMA, and CMS.gov but none of these state anything about not billing with a preventive visit. Any input/advice would be greatly appreciated!
I work at a Pediatric Clinic in MS. We have a claim where we are billing for the ear wash 69209 (for impacted cerumen removal) while being done during a well visit (99393). We have the appropriate modifiers attached to the codes but Magnolia MSCAN denied 69209 as "x9 Procedure Codes Pair Incidental, Mutually exclusive or unbundled." Can the cpt code 69209 not be billed along with a wellness exam?
We coded the claim as follows:
99393,EP
69209,RT
3008F
99173,EP
92551,EP
note: all other codes have paid as allowed except the 69209
I have found articles from AAPC, AMA, and CMS.gov but none of these state anything about not billing with a preventive visit. Any input/advice would be greatly appreciated!