Otolaryngology Coding Alert

Reader Question:

Ear Wick Placement Part of E/M Service

Question: Is there a code for placement of an ear wick?

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Answer: Typically ear wicks are used to provide constant medication and secondary relief to patients with otitis externa (380.10), in which the ear canal becomes very swollen. The wick is saturated with antibiotics and placed directly in the ear canal to attack the infection.

There is no code for placement of an ear wick. And because most carriers will not separately reimburse this service, there is no reason to use an unlisted code. Instead, this service should be included in the appropriate level of evaluation and management service, says Ann Hughes, CPC, a practice coder with Mid-Vermont ENT in Rutland.

Sometimes, the otolaryngologist may use the microscope to place the ear wick. In this case 92504 (binocular microscopy [separate diagnostic procedure]) may be billed. Alternatively, 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.
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