Does a physician have to remove cerumen to bill 69210 or 69209 or can a nurse remove it and still bill? Has anyone billed the 69209 and what is the reimbursement for it?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Cerumen Removal - Does a physician have to remov
- Thread starter harlisgrandma@hotmail.com
- Start date
-
- Tags
- 69209 bill cerumen reimbursement remove
ehanna
Guru
69210 requires the doctor perform the procedure and document instrumentation with diagnosis of cerumen impaction. 69209 can be done by the MA/Nurse as long as there is a cerumen impaction documented. this can be done by irrigation only.
I hope this helps
Does there have to be an order from the provider before the MA can perform this procedure? Is an e/m code able to be billed on the same day? For instance, if patient sees the doctor for ear pain and then the MA does the removal of impacted cerumen, can we bill both the appropriate e/m code and 69209? What if patient sees the doctor for something unrelated, can 69209 be billed too?
ehanna
Guru
You can bill the 69209, along with the E&M, as long as the record supports the cerumen impaction. -25 modifier on the level.
I hope this helps
lesia0131
New
can you bill the 69210 for each ear or is it only billed once for both ears
ehanna
Guru
If you read your CPT you will see 69210 is a unilateral code. Report modifier -50 if bilateral. There is a lot of good information in your CPT!!
valleycoder
Expert
Medicare will not reimburse for bilateral so using modifier -50 depends on the payer.