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G0268 (Removal of impacted cerumen [one or both ears] by physician on same date of service as audiologic function testing) is for a Medicare patient when the physician removes impacted cerumen on the same day that audiology is performed and it is still report G0268 for either one or both ears. When reporting cerumen removal for a Medicare patient, submit G0268 if audiology is also performed that day. Report 69210 (Removal impacted cerumen requiring instrumentation, unilateral) if no audiology is performed. G0268 remains a unilateral/bilateral code. Unfortunately, Medicare is treating 69210 just like G0268 and paying it the same amount whether it was performed unilaterally or bilaterally. Also note that, some Medicare carriers are actually denying 69210 if it is submitted with a 50 modifier even though AMA CPT® calls for the 50 modifier when performed bilaterally, check if you have appended modifier. On the other hand CPT 69210 and 92567 billing together, CPT 69210 will be denied always, as code 69210 is a column 2 code for 92567, these codes cannot be billed together in any circumstances, per CCI edits rule.
Hi Barbara,
Hope you are keeing well.
Since, this query date back long time, so it is requested to post it new tread.
Thank you!