I have a question regarding cerumen impaction and removal. I am aware that if the physician performs a simple ear lavage, you can't use CPT code 69210. The procedure is included in the E/M service. In order to use the CPT code 69210, the cerumen must have been removed with some sort of instrumentation. Does the removal with the insrumentation only have to be done by a physician to use 69210, or can a nurse perform the removal with instrumentation and use 69210? Can someone please point me to written guidance on this issue, please? Thanks.