Removal impacted cerumen


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PLEASE HELP- Not familiar with ENT coding. When billing MEDICARE for the removal of impacted cerumen (69210) can anyone advise on requirements?
I know it's a seperate billable procedure, but, we no longer have a ENT dr on site, only certified audiologists.

Can I bill? Thanks for any help.

Donna W

Yes, you can bill for the cerumen removal - just be sure that if a "separately identifiable" e/m is done on the same dos, you use a modifier -25.

Also, make sure that the dx is for "impacted cerumen" - 380.4.

Also, this code is for either one or both ears - does not need a -50 modifier.

Hope this helps!
The way I understand it, the cerumen must be removed by the doctor utilizing a cerumen spoon or forceps. It cannot be a simple flush performed by ancillary staff.