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Otolaryngology Coding Alert

READER QUESTIONS :

Use HCPCS Code for Cerumen Removal Before Test

Published on Wed Apr 15, 2009

Question: Ive lost an appeal on 69210 being billed on the same day as 92567. Im told the rationale for upholding the denial is: CPT code 69210 is incidental to CPT code 92567 and is not separately reimbursed per the ERM, CMS and Encoder Pro. In addition, modifiers are not allowed. Rhode Island Subscriber Answer: Theres a special HCPCS code just for this situation. When your physician removes impacted earwax so your audiologist can perform diagnostics, you report G0268 (Removal of impacted cerumen [one or both ears] by physician on same date of service as audiologic function testing). Thats assuming that your physician is removing the earwax separate from the audiologist testing. Medicare will not pay for an audiologist to remove ear wax; 69210 (Removal impacted cerumen [separate procedure], 1 or both ears) is a surgical code. Medicares policy states that audiologists may only perform diagnostic procedures, such as 92567 [...]
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