Wiki Help me with 69210 please

[Peanut011]

69210 states that it is unilateral and I cannot get paid for bilateral. What is the correct way to bill bilateral 69210 to Medicare??
Thank you.

 

[Cynthia Hughes]

Medicare 69210

69210 states that it is unilateral and I cannot get paid for bilateral. What is the correct way to bill bilateral 69210 to Medicare??
Thank you.

Hi,

Medicare did not agree with CPT's descriptor of unilateral for the removal of impacted cerumen and will not allow additional payment when billed as bilateral. The Medicare Physician Fee Schedule shows a 2 in the "Bilateral Surgery" column for code 69210. The 2 indicates the RVUs are already based on the procedure being bilateral and no additional payment will be made when reported as bilateral. I hope that helps.

Cindy

 

[Stacey Walden]

G0268?

Our previous biller had started trying G0268 for cerumen removal instead of 69210. Would this be an appropriate substitution?

 

[thomas7331]

G0268 is specifically for cerumen removal done by the physician on the same day as an audiology/hearing test so isn't interchangeable with 69210. The bilateral indicator for both codes are also the same, so it wouldn't result in an increased payment in any case.