Wiki Bilateral cerumen - 1 side impacted the other not impacted

[Lainie0559]

How do you code patients who come in for cerumen care only where 1 side is impacted and the other is not impacted?

Guidelines say if it's not impacted to bill an office visit but if it is impacted to bill the 69210. So if a carrier will pay for bilateral cerumen removal, do you bill an office visit for the non-impacted cerumen along with 69210 for the removal of the impaction? Or do you just bill for the 69210 for the one side?

Any comments and thoughts are greatly appreciated.

 

[rthomas@impcna.com]

How do you code patients who come in for cerumen care only where 1 side is impacted and the other is not impacted?

Guidelines say if it's not impacted to bill an office visit but if it is impacted to bill the 69210. So if a carrier will pay for bilateral cerumen removal, do you bill an office visit for the non-impacted cerumen along with 69210 for the removal of the impaction? Or do you just bill for the 69210 for the one side?

Any comments and thoughts are greatly appreciated.

In the practice I work for if the reason for the appointment was for cerumen care, patient wants ears washed out or something to that nature we only charge 69210 or 69209 because we knew that we would be performing the procedure. Now if the patient was scheduled for an appointment for ear pain and an impaction was found on exam then the provider had to remove impaction to finish examining ear(s) I would bill an office e/m along with 69210 or 69209 depending on how impaction was removed.
These codes are unilateral codes so you can bill even if one side was impacted.