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New CPT code 69209

  1. Default New CPT code 69209
    Medical Coding Books
    I'm looking for where i can find documentation on new CPT code 69209 and if this new code has the requirement of being done by a provider? I know that cpt code 69210 although not included in the actual description of the code, in order to bill for this service, it must be provided by doctor or other health care professional and was curious if this is true for new code 69209 as well and where i can find this documentation.

    Thanks in advance

  2. #2
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    Default
    The usage of this code is explained in the CPT changes book which you will need to purchase to be able to see it. In the explanation it tells you that this procedure may be performed or supervised by the physician.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    This was in the December edition of Healthcare Business Monthly:

    Earwax Removal by
    Lavage Now a Distinct Service
    Impacted cerumen (ear wax) can cause symptoms including pain, dizziness, and loss of hearing.
    In years past, removal of impacted cerumen not requiring instrumentation has been reported
    using an appropriate evaluation and management (E/M) code. The American Medical Association
    (AMA) added a parenthetical note to CPT® 2014 instructing, “For cerumen removal that is
    not impacted [see above] or does not require instrumentation, eg, by irrigation only, see E/M
    service code, which may include new or established patient office or other outpatient services
    ….” The AMA also revised the CPT® descriptor for 69210 to specify “requiring instrumentation.”
    For 2016, the rules have changed. You may still report 69210 Removal impacted cerumen requiring
    instrumentation, unilateral for removal of cerumen requiring instrumentation; however,
    removal by lavage now has its own code, 69209 Removal impacted cerumen using irrigation/
    lavage, unilateral, and no longer is reported as an E/M service. CPT® 2016 now instructs, “for
    cerumen removal that is not impacted, see E/M service code….”
    Note that both 69209 and 69210 are unilateral procedures; for removal of impacted cerumen
    from both ears, append modifier 50 Bilateral procedure to the appropriate code.




    Quote Originally Posted by cheryldudley8 View Post
    I'm looking for where i can find documentation on new CPT code 69209 and if this new code has the requirement of being done by a provider? I know that cpt code 69210 although not included in the actual description of the code, in order to bill for this service, it must be provided by doctor or other health care professional and was curious if this is true for new code 69209 as well and where i can find this documentation.

    Thanks in advance
    Melanie Wright, CPC

    Some days you're the bug, , some days you're the windshield.

  4. Question denial for bilateral 69209
    We have billed this code as instructed in the CPT manual, is there additional instructions for Cahaba? we used 69209 with modifier 50 1 unit, same with 2 units and seperate lines? Any input? Should we try it using RT on one line and LT on the second line? I am at a loss, I tried calling them and just when someone was picking up, I was disconnected.

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