Wiki 69209

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TLC

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Can this be billed under the doctor if a medical assistant is doing the procedure? Our MA's do a lot of the ear lavages. We stopped billing 69210 for them since it had to be done with "instruments". We would just bill a 99211 for them. Thanks
 
TLC said:
Can this be billed under the doctor if a medical assistant is doing the procedure? Our MA's do a lot of the ear lavages. We stopped billing 69210 for them since it had to be done with "instruments". We would just bill a 99211 for them. Thanks
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Yes you can :)
 
Are orders needed from the Physician if a MA is doing the services or can the patient just come in and have it done?
 
ehanna said:
Yes you can :)
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Do you have the source from where you obtained this information? I haven't seen anything in the CPT book, or from CMS or any of the associations confirming this yet. I want to make sure I have a source prior to communicating this with my providers.
 
it says qualified professionals.. and according to the CMS Part B article, it only covers RN's.

Part B News
Year: 2015
Issue: December 21
Title: New cerumen impaction removal code could add extra payment, confusion

Expect to see a Correct Coding Initiative (CCI) edit for 69209 when billed at the same time as an E/M service — an edit exists for 69210 and an E/M service.
Because the impacted cerumen removal using lavage or irrigation is typically done by a nurse, practices may see the code as a way to get paid extra for the cerumen removal because it likely wouldn’t impact the level of a medically necessary E/M service, Lewis believes.
As an example, she cites a patient who presents to the office with ear pain. The physician would do the full workup for the problem-focused visit, and one element of the medical decision-making would be to discover and remove the impacted cerumen.
If instrumentation is not needed, then the cerumen removal would be done by the nurse, and the practice would bill 69209.


https://www.encoderpro.com/epro/coderEssential3PackContentOnlyHandler.do?_k=3039*521149&_a=view
 
Look under rationale second paragraph. It states performed or supervised by physician or qualified non physician practitioner. The physician or NPP must be on site. Then in the clinical example it states the physician gives the order fir the nurse to irrigate the ear.
 
mitchellde said:
Look under rationale second paragraph. It states performed or supervised by physician or qualified non physician practitioner. The physician or NPP must be on site. Then in the clinical example it states the physician gives the order fir the nurse to irrigate the ear.
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Correct, again it says Nurse or NPP. And Non Physician Practitioner is NOT an MA. A qualified nonphysician practitioner is a nurse practitioner, physician assistant or
clinical nurse specialist.
 
It says supervised by physician or NPP. As long as the other ancillary person is employed by the physician and is qualified to perform the task, they fall into the same category as an RN. RNs and MAs and LPNs all fall into the category of "other qualified ancillary staff". They are not NPPs. So as long as it is performed by a qualified staff person and an NPP or physician is supervising then yes.
 
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