Primary Care Coding Alert

Question: The physician administered anesthesia before removing a bead from each of a child's ears. Do we append modifier 50 to the code for the second ear? New Jersey Subscriber Answer: The code you'll report, 69205 (Removal foreign body from external auditory canal; with general anesthesia) stipulates "foreign body" in the descriptor as singular, not plural. Because of this, you can report removal from each ear separately. Also note that 69205 is a unilateral code, so you need to bill for the removals per ear. Here's how: According to the Medicare fee schedule, modifier 50 (Bilateral procedure) does not apply to code 69205. Instead, you should indicate a separate site (left ear from right ear) by appending modifier 59 (Distinct procedural service) to the second ear procedure. You might also want to append modifier LT (Left side) and RT (Right side) to 69205 to identify the specific ear for clarity [...]