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99213 and 69210

John Posted Fri 05th of December, 2014 19:06:16 PM

Until now we were submitting this combination of CPT without any problems. THere is an update regarding modifier 50 [both ears]. 69210 included both ears. We are receiving rejections and contradictions from different applications. What would be the correct coding procedure? We use:
99213 - 25
69210 - no modifier

SuperCoder Answered Sat 06th of December, 2014 23:46:16 PM

The descriptor for 69210 (Removal impacted cerumen requiring instrumentation, unilateral) in 2014 revised by AMA to specify “unilateral.”

The “unilateral” detail meant providers could append modifier 50 (Bilateral procedure) when removing impacted cerumen from both of a patient’s ears during a single encounter. Hence, if the provider is performing impacted cerumen removal from both ears, bill as follows:

99213-25

69210 -50
69210- 50

Thanks !!

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