Wiki Cerumen removal under anesthesia

[calexander1265]

One of our physicians performed cerumen removal by instrumentation on a child. Because of the child's age, he performed the procedure in the ASC and the child was under anesthesia. The ASC wants to bill a 69205 because they state they will not be paid for 69210. I have said the 69205 would not be correct. I am wondering if we should bill with a -23 modifier since anesthesia was used?

 

[Cynthia Hughes]

Yes, modifier 23 is appropriate for reporting that the case required general or monitored anesthesia care due to the patient's age or other unusual circumstance. Most payment policies require the anesthesia provider to list first the anesthesia modifiers such as AA and then modifier 23.