Wiki Help billing for wax surveillance when there is no wax

[kcouncil]

Hello All!

Im in search of feedback on how to code a particular visit. A patient has no voiced pain issues just states that there is a lot of wax in ears and they have to wipe their ears out. A Provider examines the patients ears and documents that both ears are free of cerumen. The codes provided for billing are 99212 with Dx code Z01.10 (encounter exam of ears and hearing w/o abnormalities). Medicare denied this claim as non covered when considered routine. I am aware that Z01.10 would usually be billed with routine and well visits ;so how should this visit be coded? Does the procedure code need to be changed? Would we not be able to bill for this service?

Thank you all for your answers and feedback!!!

 

[hblakeman]

Z03.89

Maybe Z03.89, for condition not found? I'm not sure if Medicare will pay, but it might be worth looking into.

 

[kcouncil]

Maybe Z03.89, for condition not found? I'm not sure if Medicare will pay, but it might be worth looking into.

Thank you for your help!! I looked up Z03.89 and I think that code is the best choice. While researching code Z03.89 I came across another AAPC thread that suggested using code Z03.89 as the primary code and coding the symptom secondary in order to show that there was a symptom but it was ruled out.