What does CPT code 69210 mean?

What does CPT code 69210 mean?

69210, Removal impacted cerumen requiring instrumentation, unilateral.

How do you bill CPT 69210 bilateral?

A: The coder would report CPT code 69210 (removal impacted cerumen requiring instrumentation, unilateral) with modifier -50 (bilateral procedure) twice. Alternatively, the coder could report code 69210 twice with modifiers -LT (left side) and -RT (right side).

What is CPT code for ear lavage?

A new CPT code, 69209, provides a specific billing code for removal of impacted cerumen using irrigation/lavage. Like CPT 69210, (removal of impacted cerumen requiring instrumentation, unilateral) 69209 requires that a physician or qualified healthcare professional make the decision to irrigate/lavage.

How do you bill for ear wax removal?

Removal of impacted cerumen is represented by the following two CPT codes:

1. 69209 – Removal impacted cerumen using irrigation/lavage, unilateral.
2. 69210 – Removal impacted cerumen requiring instrumentation, unilateral.

Does Medicare cover 69210?

Medicare cannot reimburse audiologists for CPT code 69210 or HCPCS code G0268 under any circumstances.

Can 69210 and 92567 be billed together?

e. 69210 is not to be used for billing of removal of non-impacted cerumen – use an appropriate E&M code instead. 3 g. 69210 is allowed when billed in conjunction with one of the following: 92550, 92552, 92553, 92556, 92567, 92570, 92579, 92582, 92587.

Is 69210 a surgical procedure?

A.No. Code 69210 is defined as “removal impacted cerumen (separate procedure), one or both ears.” Use this same code only once to indicate that the procedure was performed, whether it involved removal of impacted cerumen from one or both ears.

Does Medicare pay for 69210?

Does 69210 need a modifier?

When you are using 69210 for ear wax impaction, it is appropriate to use an E/M code (with modifier -25) if the patient received a true evaluation and management for a separate problem (such as bronchitis or pharyngitis) or for complicating problems (such as dizziness or otitis media).

What is the difference between 69210 and 69209?

Code 69210 captures the direct method of impacted earwax removal using curettes, hooks, forceps, and suction. CPT® 69209 Removal impacted cerumen using irrigation/lavage, unilateral reports removal of impacted cerumen (earwax) by irrigation and/or lavage.

Can you bill an office visit with 69210?

Is it appropriate to bill the 99211 with the 69210? A. Since no physician work was required, you should not use code 69210. Instead, you would only bill 99211.

Who can perform 69210?

Historically, many payers have required a physician to provide the service. Some payers continue to observe this restriction, while others may allow an NPP (such as nurse practitioner, physician assistant, or clinical nurse specialist) to perform and report 69210.

Is 69210 an unilateral or bilateral code?

Removal of cerumen that does not meet the criteria required under the new definition is considered to be included in the evaluation and management service rendered. procedure also defines procedure code 69210 as a “unilateral” procedure that should be reported using a -50 modifier (bilateral procedure) if performed on both ears.

Does Medicare cover 69210 CPT?

However, Medicare can pay audiologists only for medically necessary diagnostic testing, which is considered to include any incidental cerumen removal by the audiologist. Medicare cannot reimburse audiologists for CPT code 69210 or HCPCS code G0268 under any circumstances.

Medicare reimbursement for 69210 will only be made for one unit of service, regardless of whether one or two ears are involved. UCare will follow Medicare guidelines and will process claims for procedure code 69210 based on a unit of one. Claims submitted with a -50 modifier will deny.

Do you need a modifier for 69210?

The doctor detects impacted cerumen and removes it, billing 69210. Although modifier -25 is not technically required because 69210 is not a starred procedure and not bundled with 99392 ( early childhood [age 1 through 4 years]), you should still use the modifier.