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Norelie Posted Tue 06th of January, 2015 12:23:48 PM

I've been billing G0268 for medicaid when I have an office visit and audios. Medicaid states this is not a covered service. When I tried billing 69210 instead, it's denying because it's bundled. Is anyone else having this issue?

SuperCoder Answered Wed 07th of January, 2015 03:52:03 AM

You should report G0268 (Removal of impacted cerumen [one or both ears] by physician on same date of service as audiologic function testing) when cerumen removal meets three criteria. First, the otolaryngologist must perform the procedure on the same date of service as audiologic function testing. Second, the cerumen removal must be too complicated for the audiologist to perform, meaning it is truly impacted, so the otolaryngologist must perform the procedure. Third, the audio and the cerumen impaction must contain different diagnoses.

You can't bill 69210 to Medicaid. It should be used with private payers only.

Thanks !!

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