Question Foreign Body Removal for Otitis Externa???

jaim0214

New
Messages
3
Location
Green Valley, AZ
Best answers
0
Provider wants to code CPT 69200 "Foreign Body Removal from external auditory canal" for cleaning a patient's ear due to otitis externa/swimmer's ear
Provider says the infection shouldn't be there so it is a foreign body. He used scope to visualize, clean ear and placed an ear wick.
Is 69200 correct??? or should an E/M be coded? Or something else?
 
Last edited:

SharonCollachi

True Blue
Messages
1,201
Location
Clovis, CA
Best answers
3
Cancer shouldn't be there either, but it's not a foreign body. I think he's stretching to get paid for a procedure when it is merely an E&M code.
 

SharonCollachi

True Blue
Messages
1,201
Location
Clovis, CA
Best answers
3
I have never come across this reasoning before
Foreign body/object is referring for example a bead, lego, bean, insect etc. only correct?
Yes, something that isn't found in the body. Bullet fragments, metal pieces, toys, beans, gravel, sticks, etc. Not a typical body process such as an infection or a tumor.
 

jackjones62

Expert
Messages
258
Location
Niantic, CT
Best answers
1
So, I agree, your provider is stretching the term "foreign body" but he can bill CPT 92504 for the use of Binocular Microscopy for the placement of the earwick. If he used an otoscope to do this than he cannot bill. If he bills the E/M and wick placement using 92504 be sure their documentation supports both services.

Tips From AAPC Coder
Do not report the diagnostic or treatment procedures like otoscopy, anterior rhinoscopy, removal of nonimpacted cerumen, or tuning fork test, separately if the provider reports them as evaluation and management services; 92504 is a special diagnostic test that is not included in an evaluation and management service.

Report 92504 when the provider performs no other related ear procedure during the same visit. For example, if an otolaryngologist suspects a foreign body in a patient's ear, looks in the ear, and doesn't find it. Because no object was found for removal, report the examination only using 92504. If the provider removes a foreign body from the external auditory canal, you would instead code the foreign body removal 69200, Removal foreign body from the external auditory canal; without general anesthesia.

Similarly, you should report 92504 for placing an earwick because no code exists for this procedure.

Also, report the code 92504 when the provider uses the binocular microscope and performs an unrelated procedure. For example, if an otolaryngologist looks in a patient's ear and also performs a nasal endoscopy. Because the ear examination and nasal endoscopy occur on separate body areas, report both procedures. Append modifier 59, Distinct procedural service, to 92504 to indicate the microscopy as a distinct procedural service from 31231, Nasal endoscopy, diagnostic, unilateral or bilateral, separate procedure.

Do not append modifier 59 when a more specific modifier, such as XE (same date, separate encounter), XP (different practitioner), XS (separate organ or structure), or XU (service does not overlap with the usual components of the main service). Documentation must support the use of the modifier. Do not confuse modifier 59 with modifier 51 for multiple procedures (e.g., same procedure on different anatomic sites, related procedures on the same anatomic site, or the same procedure multiple times on the same anatomic site).

Hope this helps!

Jennifer
Coding Analyst
 

jaim0214

New
Messages
3
Location
Green Valley, AZ
Best answers
0
So, I agree, your provider is stretching the term "foreign body" but he can bill CPT 92504 for the use of Binocular Microscopy for the placement of the earwick. If he used an otoscope to do this than he cannot bill. If he bills the E/M and wick placement using 92504 be sure their documentation supports both services.

Tips From AAPC Coder
Do not report the diagnostic or treatment procedures like otoscopy, anterior rhinoscopy, removal of nonimpacted cerumen, or tuning fork test, separately if the provider reports them as evaluation and management services; 92504 is a special diagnostic test that is not included in an evaluation and management service.

Report 92504 when the provider performs no other related ear procedure during the same visit. For example, if an otolaryngologist suspects a foreign body in a patient's ear, looks in the ear, and doesn't find it. Because no object was found for removal, report the examination only using 92504. If the provider removes a foreign body from the external auditory canal, you would instead code the foreign body removal 69200, Removal foreign body from the external auditory canal; without general anesthesia.

Similarly, you should report 92504 for placing an earwick because no code exists for this procedure.

Also, report the code 92504 when the provider uses the binocular microscope and performs an unrelated procedure. For example, if an otolaryngologist looks in a patient's ear and also performs a nasal endoscopy. Because the ear examination and nasal endoscopy occur on separate body areas, report both procedures. Append modifier 59, Distinct procedural service, to 92504 to indicate the microscopy as a distinct procedural service from 31231, Nasal endoscopy, diagnostic, unilateral or bilateral, separate procedure.

Do not append modifier 59 when a more specific modifier, such as XE (same date, separate encounter), XP (different practitioner), XS (separate organ or structure), or XU (service does not overlap with the usual components of the main service). Documentation must support the use of the modifier. Do not confuse modifier 59 with modifier 51 for multiple procedures (e.g., same procedure on different anatomic sites, related procedures on the same anatomic site, or the same procedure multiple times on the same anatomic site).

Hope this helps!

Jennifer
Coding Analyst
Thank you so much!
 

jackjones62

Expert
Messages
258
Location
Niantic, CT
Best answers
1
No, ear debridement for swimmers ear is considered bundled with the E/M, hence no CPT code. But, when a ear wick is placed you can bill for the microscopy if utilized. Summers ear is the an inflammation and swelling of the canal, the inflammation causes oozing and crusting, usually the provider will suction out the debris, apply drops and place the ear wick, it's straightfoward. But because most of the time it requires the microscopy you can bill for the microscopy separately.
 
Top