Pediatric Coding Alert

Question: Has injection administration (96372) always been bundled with 69210?  I just received a rejection on this but I don't recall these codes being bundled before. Our patient came in for multiple problems and she received an ear lavage with additional manual impacted cerumen removal and a B12 injection.

Kansas Subscriber

Answer: Although the edit doesn't appear to make any sense, there is indeed a CCI edit that bundles 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) into 69210 (Removal impacted cerumen [separate procedure], 1 or both ears).

The good news: This edit has a modifier of "1," which means that you can use a modifier (such as 59, Distinct procedural service) to separate the edit if you perform separate, medically necessary services on the same date of service.