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Bilateral G0268 payment

Norelie Posted Tue 16th of September, 2014 13:14:04 PM

We use the G0268 code when cerumen impaction is performed with an audiology on the same day for payers such as UHC, Aetna, etc. These payers pay for bilateral 69210, can you use -50 with G0268 also?

SuperCoder Answered Wed 17th of September, 2014 11:24:14 AM

Thank you for your question.
Modifier 50 would not be used on G0268. Please see the Clinical Responsibility outlined below.
Clinical Responsibility

This service is for removal of wax in which a physician's skill is required. This procedure is applicable when the patient approaches with any hearing problem and the physician finds the ear canal are blocked with wax, and the ear canal are cleared on the same day of audiologic function testing. Medicare provides coverage for this service if the wax removal requires a physician's skill or the procedure is supervised by a physician. Significant amount of time and effort should be dedicated for the procedure to claim for the service. Even if the procedure is done on both ears, the service should be reported as one unit.

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