Otolaryngology Coding Alert

Question: Does a code exist to describe placement of an ear wick? Virginia Subscriber Answer: Otolaryngologists typically 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 very swollen. The physician saturates the wick with antibiotics and places it directly in the ear canal to attack the infection. CPT does not provide a code for placement of an ear wick. In addition, most carriers will not separately reimburse this service. Therefore, no reason exists to use an unlisted-procedure code. Instead, include this service in the appropriate level of E/M service (99201-99215, Office visit for a new or established patient). Sometimes, the otolaryngologist may use a microscope to place the ear wick. In this case, you should bill 92504 (Binocular microscopy [separate diagnostic procedure]). 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.