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How do you code impacted cerumen removal (69210) from both ears?

obinna Posted Thu 11th of December, 2014 13:17:02 PM

I would greatly appreciate it

SuperCoder Answered Thu 11th of December, 2014 13:22:54 PM

You would bill 69210-50.

The provider must use instrumentation such as a curette, vacuum evacuation or forceps, to remove entrapped wax from a patient's external auditory canal.

If no instrumentation and only lavage was used for the removal it is considered part of the E/M service.

Hope this helps.

obinna Posted Fri 12th of December, 2014 12:18:50 PM

Is it true in some instances that you would code 69210-50 twice? Like this:

69210-50
69210-50

SuperCoder Answered Fri 12th of December, 2014 12:23:23 PM

No you cannot bill like that. The 50 modifier is for bilateral and reflects removal from both ears.

In some instances a payer may require billing 69210-RT and 69210-LT. You should check with your payer to determine how they want in billed.

Hope this helps.

obinna Posted Fri 12th of December, 2014 15:55:07 PM

Does modifier 50 increase the payment for 69210?

Medicaid pays $43.91 for 69210, so would modifier 50 make it $87.82 ($43.91 x 2)?

SuperCoder Answered Fri 12th of December, 2014 16:46:16 PM

Yes, the payment would increase as the modifier 50 is indicating to the payer that the procedure was done on both ears.

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