Wiki ear irrigation

[jmcalister]

I know the use of 69210 has been discussed several times but when brought up with our providers it gets to be touchy subject. I read the description that a physcian needs to perform the irrigation and that they need to use an instrument. At our facility, the nurse does almost all the irriagations by flushing when talking to our nurses they said almost always there is no need for the doctor to flush because they got the cerumen out. So I am wondering if the nurses can continure to flush but the doctor needs to go behind them and look and then dictate that he did look and examine the ears after done. Thanks for any help on this subject.

 

[RebeccaWoodward*]

I know the use of 69210 has been discussed several times but when brought up with our providers it gets to be touchy subject. I read the description that a physcian needs to perform the irrigation and that they need to use an instrument. At our facility, the nurse does almost all the irriagations by flushing when talking to our nurses they said almost always there is no need for the doctor to flush because they got the cerumen out. So I am wondering if the nurses can continure to flush but the doctor needs to go behind them and look and then dictate that he did look and examine the ears after done. Thanks for any help on this subject.

Ear wax removal via lavage or irrigation is not payable. Flushing the ears, checking and examining the ears does not warrant 69210. If the provider wants to bill 69210, the cerumen must be impacted using at minimum an otoscope and instruments such as wax curettes, etc as the method of removal. If the nurse irrigates the ear and the physician examines the ear and determines that there is still impacted cerumen that requires removal by the provider (as stated above), I could see billing this with good documenation.

 

[FTessaBartels]

Bill the E/M

You WOULD, however, be able to bill the documented E/M level.

F Tessa Bartels, CPC, CEMC