ED Coding and Reimbursement Alert

Reader Questions :

Ear Wick Won't Equal Procedure Code

Question: A 34-year-old male patient reports to the ED complaining of pain and itching in his inner right ear. The ED physician performs a history and exam, reaching a diagnosis of infected otitis externa. The physician delivers liquid antibiotics via a small wick into the patient's ear canal. I cannot find a code for this type of treatment. Can I report 69210 for this scenario?

Ohio Subscriber

Answer: You cannot submit a procedure code for ear wick treatment. The 69210 (Removal impacted cerumen [separate procedure], 1 or both ears) code is only for impacted cerumen removal.

Best bet: Consider the ear wick insertion part of your physician's E/M service and choose the ED E/M code that best represents the encounter (99281-99285, Emergency department visit for the evaluation and management of a patient, which requires these 3 key components ...).

Also, append 380.10 (Infective otitis externa, unspecified) to the E/M code to prove medical necessity for the visit.

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