Internal Medicine Coding Alert

Reader Question:

Roll Ear-Wick Placement Into E/M Service

Question: Which code should I assign for the internist inserting a wick in a patient's ear?

California Subscriber

Answer: CPT does not provide a code for ear-wick placement, and most carriers will not separately reimburse this service. Therefore, you should include this service in the appropriate level of E/M service (99201-99215, Office visit for a new or established patient). Depending on the complexity of the disease process and the diagnosis, placing the ear wick can boost the level of medical decision-making, which in turn may increase the level of E/M service.
 
Internists often use ear wicks to provide constant medication and secondary relief to patients with otitis externa (380.10, Infective otitis externa, unspecified), in which the ear canal becomes swollen. The physician saturates the wick with antibiotics and places it directly in the ear canal to attack the patient's infection.

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