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Wiki cpc - with cpt code
- Thread starter andrews24
- Start date
btadlock1
Guest
More than likely, as long as the records show a distinct difference in the E/M services and the earwax removal. As long as removing the cerumen is not a vital step in evaluating or treating the patient (like it would be if they came in complaining of ear pain, for example), and the E/M elements are clearly documented, it's a separately billable service. (Check with your local Medicare/Medicaid providers, though, for specifics on their coverage criteria. My background is commercial insurance.
It is a procedure that's treated like a surgery for modifier purposes (much like 96372 is). If documentation supports billing both, the E/M will require a 25 modifier to process. Otherwise, it will deny as incidental to 69210. Hope that helps!
It is a procedure that's treated like a surgery for modifier purposes (much like 96372 is). If documentation supports billing both, the E/M will require a 25 modifier to process. Otherwise, it will deny as incidental to 69210. Hope that helps!
FTessaBartels
Guest
Please NOTE
Please note - IRRIGATION does NOT equal CPT 69210. Documentation for 69210 MUST include a physician diagnosis of impacted cerumen, and must include procedure description that involves the use of instruments to remove the impacted cerumen.
There must be at least a dozen posts on this forum on this topic. You might want to research and read them.
F Tessa Bartels, CPC, CEMC
Please note - IRRIGATION does NOT equal CPT 69210. Documentation for 69210 MUST include a physician diagnosis of impacted cerumen, and must include procedure description that involves the use of instruments to remove the impacted cerumen.
There must be at least a dozen posts on this forum on this topic. You might want to research and read them.
F Tessa Bartels, CPC, CEMC