Wiki Can I bill cpt code 69210 twice if the procedure is done for bilateral ears?

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kiranmaik12 said:
Can I bill cpt code 69210 twice if the procedure is done for bilateral ears?
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The description of the code states unilateral, so you could bill separately for both ears. Some providers may want one line with a modifier 50. Medicare only allows one unit even if both ears are treated.

Below is cut and paste from EncoderPro coding tips for that code:

These codes describe removal of cerumen impaction. Report unimpacted cerumen removal with the appropriate E/M service code. Do not report these codes together when performed on the same ear. These codes describe unilateral procedures. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers. Modifier 50 identifies a procedure performed identically on the opposite side of the body (mirror image). Medicare allows only one unit of this code to be billed even if both ears are treated. Medicare and some other payers may require that HCPCS Level II code G0268 be reported for removal of impacted cerumen (one or both ears) by a physician on the same date of service as audiologic function testing.
 
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sls314 said:
The description of the code states unilateral, so you could bill separately for both ears. Some providers may want one line with a modifier 50. Medicare only allows one unit even if both ears are treated.

Below is cut and paste from EncoderPro coding tips for that code:

These codes describe removal of cerumen impaction. Report unimpacted cerumen removal with the appropriate E/M service code. Do not report these codes together when performed on the same ear. These codes describe unilateral procedures. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers. Modifier 50 identifies a procedure performed identically on the opposite side of the body (mirror image). Medicare allows only one unit of this code to be billed even if both ears are treated. Medicare and some other payers may require that HCPCS Level II code G0268 be reported for removal of impacted cerumen (one or both ears) by a physician on the same date of service as audiologic function testing.
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Thanks for the reply
 
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I WORK FOR ENT IN VICTORIA TEXAS THERE IS ONLY 1 INSURANCE THAT WE BILL (OR WILL ALLOW) BILATERAL BILLING. BCBS IS THE ONLY INSURANCE THAT WILL PAY FOR BILATERAL CERUMEN REMOVAL BILLED WITH MODIFIER 50 DOUBLE THE PRICE. ALL THE OTHER INSURANCE ONLY COVER ONCE.
 
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