Pediatric Coding Alert

Reader Question:

Roll Ear-Wick Placement Into E/M Service

Question: Which code should I assign for inserting a wick in a childs ear?

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Answer: Pediatricians 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, 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.
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