Modifier 33 - approprite codes

Kachina Coders
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We have not begun using the modifer 33 due to confusion in the office as to how exactly we are to be using this modifier. Can anyone explain to me how exactly we are to use this modifier? I'm aware of the USPSTF A/B rating scale and that we can use this modifier with the approprite codes listed on this. But are there any other instances in which the modifier 33 should be used?

For example, it has been asked, if a patient comes in for a wcc 99392, in addition we do a sick visit 99213 because the patient at TOS complains of an earache. After examination, it is determined a cerumen removal is required, 69210. Would this be billed as...

99392 - 33
99213 - 25

And if this is allowed can the insurance still apply a cp/ded/coins to the patient for the office visit/cerumen removal or is this still exempt due to the primary reason for the visit being a well exam??? :confused:

Thanks in advance,

Cheryl Miles, CPC