Billing CPT 69209 - Ear Lavage

LeaHarris

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So excited to see this new code added. Can anyone clarify if this code can still be used in conjunction with an E/M service as long as additional diagnosis' were covered to associate with the E/M?
 

caramella025

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This was in the December edition of Healthcare Business Monthly:

Earwax Removal by
Lavage Now a Distinct Service
Impacted cerumen (ear wax) can cause symptoms including pain, dizziness, and loss of hearing.
In years past, removal of impacted cerumen not requiring instrumentation has been reported
using an appropriate evaluation and management (E/M) code. The American Medical Association
(AMA) added a parenthetical note to CPT® 2014 instructing, “For cerumen removal that is
not impacted [see above] or does not require instrumentation, eg, by irrigation only, see E/M
service code, which may include new or established patient office or other outpatient services
….” The AMA also revised the CPT® descriptor for 69210 to specify “requiring instrumentation.”
For 2016, the rules have changed. You may still report 69210 Removal impacted cerumen requiring
instrumentation, unilateral for removal of cerumen requiring instrumentation; however,
removal by lavage now has its own code, 69209 Removal impacted cerumen using irrigation/
lavage, unilateral, and no longer is reported as an E/M service. CPT® 2016 now instructs, “for
cerumen removal that is not impacted, see E/M service code….”
Note that both 69209 and 69210 are unilateral procedures; for removal of impacted cerumen
from both ears, append modifier 50 Bilateral procedure to the appropriate code.


So excited to see this new code added. Can anyone clarify if this code can still be used in conjunction with an E/M service as long as additional diagnosis' were covered to associate with the E/M?
 
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