Wiki Code 69210 - Urgent Care

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Can you bill code 69210 (removal impacted ear wax) on top of the E/M code? What if the Medical Asst. removed the ear wax, not the MD?

Thank you.
That code is a physician procedure and involves the use of instruments an MA is not qualified to use. If the provider performs the procedure using a scoop or currette and documents a procedure note and it meets the qualifications for the use of the 25 modifier then yes it may be billed with an E& M.
Possibly but that does not qualify for the 69210. 69210 is not an irrigation code it is to be used when the provider uses a scoop or currette.
I don't want to beat a dead horse, because I felt like I fully understood this until I read this in the description, "Code Description 69210 Removal impacted cerumen (separate procedure), 1 or both ears

Lay Description: Under direct visualization, the physician removes impacted cerumen (ear wax) using suction, a cerumen spoon or delicate forceps. If no infection is present, the ear canal may be irrigated."

Why does the last sentence say it may be irrigated if irrigation is not eligible for billing a 69210?

I've always told my staff that to bill a 69210 an MD must have done the procedure and it must have required the SKILL of a physician (to make sure that they don't have the MD do the irrigation just to get paid for it.) This is throwing me off. Please clarify and put my mind at ease. LOL.