Wiki cerumen removal help!

TLC

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I know this has come up before. I can't find in "writing" where is states only a physician can remove cerumen. My CPT book just states "removal impacted cerumen 1 or both ears". I thought I saw once where it stated a nurse/MA could not remove. Also if it is only done by "water lavage" that is not billable??? Sometimes a patient comes in for a nurse visit for a ear lavage. If they are not suppose to bill for it how should a nurse visit for this be coded? Thank you
ps If anyone knows where I could find this in writing.
 
I believe CPT69210 specifically is required to be performed by a physician and use of a "simple lavage" is not considered billable under this code. I do not have reference to what the nurse should report but I believe the issue of cerumen removal is addressed in CPT Asst. '05 July, page 14.
 
I found a couple of resources for you to support when cerumen removal is billable. Only a physician (this would include midlevels) has the skill and training to remove impacted cerumen with a tool per CMS. Lavage cannot be billed, if the documentation supports a 99211 then that would be the only option for ancillary staff services.

Cahaba - MCR Mac LCD:
http://www.cahabagba.com/news/local...erumen-evaluation-management-services-a52356/

Previous AAPC thread with CMS source:
https://www.aapc.com/memberarea/forums/showthread.php?t=22500

CMS reimburses physicians under the following two codes:
1.G0268 Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing

◾CMS explains that the code was created in order to allow payment to a physician who removes impacted cerumen on the same date as a contracted or employed audiologist who performs audiologic function testing.

...routine removal of cerumen is not paid separately. It is considered to be part of the procedure with which it is billed (for example, audiologic function testing)...This code should not be used when the audiologist removes cerumen, because removal of cerumen is considered to be part of the diagnostic testing and is not paid separately.
Source: Federal Register, December 31, 2002, pp. 80011–12

Source: Coding Clinic; 2003, Q1, P12
2.69210 Removal of impacted cerumen (separate procedure), 1 or both ears
◾According to the CPT Assistant (July 2005), "Removing wax that is not impacted does not warrant the reporting of CPT code 69210." This code should only be used by a physician on a day when no audiologic function tests occur.

The American Academy of Otolaryngology-Head and Neck Surgery collaborated with the American Medical Association CPT Assistant (July 2005) and provided four considerations, each of which defines impacted cerumen:
◾Visual: cerumen impairs exam of significant portions of the external auditory canal, tympanic membrane, or middle ear condition
◾Qualitative: extremely hard, dry, irritative cerumen
◾Inflammatory: associated with foul odor, infection, or dermatitis
◾Quantitative: obstructive, copious cerumen that cannot be removed without magnification and multiple instrumentations

They also said that billing for impacted cerumen removal is appropriate if removal requires the use of at least an otoscope and instrumentation such as wax curettes.
 
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