Wiki E&M with Cerumen Removal

[cmh08]

Hi all,

I have a coding question. How is your office coding an E&M with ear wax removal? Do you append a mod 25 on the E&M? What mod do you append to the 96209 or 96210? This is for commercial insurance only for reimbursement.

Thanks,
Charity

 

[jrclark1987@yahoo.com]

Hi all,

I have a coding question. How is your office coding an E&M with ear wax removal? Do you append a mod 25 on the E&M? What mod do you append to the 96209 or 96210? This is for commercial insurance only for reimbursement.

Thanks,
Charity

I AM IN KY. We append 25 to the E/M with separate diagnosis pointers and have had no issues. hope that helps.

 

[Bakins1896]

My job and I had this same discussion

It was told to me to use a modifier 25 with a lower level visit and use the 69209 if a curette was not used and use 69210 if a curette was used. Hope this helps!

 

[Stacey Walden]

We are also having issues with 69210 and E/M processing appropriately, especially with BCBS. We are appending the 25 mod to E/M but they continuously are bundling the codes.

Does anyone have any fail safe solutions to this ongoing issue?

 

[CodingKing]

We are also having issues with 69210 and E/M processing appropriately, especially with BCBS. We are appending the 25 mod to E/M but they continuously are bundling the codes.

Does anyone have any fail safe solutions to this ongoing issue?

Many payers still bundle. BCBCS NC for example has bundled it for years. - https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/bundling_guidelines.pdf

I don't know if BCBCS Kansas has changed but they used to allow w/ mod 22 after review of notes which show a minimum of 20 min spend on it. - https://www.bcbsks.com/providers/Publications/professional/newsletters/2002/s0502.pdf