Wiki Bilateral Cerumen Removal

[dballard2004]

I realize that the description for CPT code 69210 says one or both ears, but would it ever be appropriate for -50 to be added? I have a book published by Ingenix stating that modifiers 50 and 51 can be appended to this code.

Is anyone having any carriers request -50 or -51 be added? Thanks.

 

[RebeccaWoodward*]

69210 has a payment status indicator of 2 (CMS fee schedule). 2 isn't eligible for modifier 50.

 

[dballard2004]

I realize that CMS won't accept this, but do any other carriers? Ingenix says that 50 and 51 can be used with this code.

 

[RebeccaWoodward*]

I wouldn't think so since the description states "one or both ears". Now...I'm not one to make statements without some type of reference and below is an excerpt from The Coding Answer Book (1-2009)

BILATERAL PROCEDURES Overview

Bilateral surgeries are procedures performed on both sides of the body at the same operative session or on the same day. Modifier -50 is used to indicate that a procedure was performed on both sides of the body. This modifier, however, should not be used when reporting procedure codes that are primarily "bilateral" by definition. Some examples of bilateral codes: 69210 (removal impacted cerumen (separate procedure), one or both ears); and 35549 (bypass graft, with vein; aortoiliofemoral, bilateral......