2nd request-audiologic Function tests + 69210 and G0268


True Blue
Everett, Washington
Best answers
Gonna post this in the General Forum, since there's been no response in the specialty zone.

Can someone take a look at this coding and verify that the 69210 will always be bundled with these codes when performed on the same day?
92567 (modifier 51 is not used by this insurance company)
69210-59 <---I do not believe modifier 59 is appropriate here

This is for a commercial carrier and due to 69210 = a separate procedure and tha fact that the CCI edits also bundle the cerumen removal to 92557 and 92567, I'm thinking we may already have the answer? And I do know it would be improper to use modifier 59 to override the edits. Would someone kindly validate my thinking?

Additionally, when would G0268 come into play? Could this code be used IN ADDITION to the 92557 and 92567 done on the same day by the same doctor, especially if the commerial insurance company accepts it? And to anyone's knowledge would it indeed generate payment for the 69210?

Suzanne E. Byrum CPC