Results 1 to 6 of 6

Modifying 25 Cerumen Impaction.

  1. #1
    Red face Modifying 25 Cerumen Impaction.
    Medical Coding Books
    Our office is trying to find out the correct way to code an Ear Lavage in the office. My thoughts are to 25 modify the E/M because the Ear Lavage is a separate procedure, is this incorrect?


    Please help
    Thank You
    Melissa-

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    Typically, an ear lavage is inclusive to the office visit. When my phyisicians have questions about this...I always print them a copy of the AMA guidelines (already on another thread from this site)

    http://www.aapc.com/MemberArea/forum...ad.php?p=24392

  3. #3
    Default
    I understand, i may not have explained it as well as i am confused.

    if a pt comes in to our Urgent Care for ear pain, then the 69210 was done w/ an RX given would we add the 25 mod to the E/M?

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    Gotcha...In that case, Yes. Modifier 25 goes on the E/M.

  5. #5
    Location
    Oxnard local Chapter
    Posts
    7
    Default
    what if a RX was not given?

  6. #6
    Location
    North Carolina
    Posts
    3,126
    Default
    Ok...let me back up.

    If the physician removes impacted cerumen with instrumentation, you can report 69210 for the service. If the physician/NPP removes the cerumen with lavages or other solutions, personally, I wouldn't report 69210.

    “Impacted” definition: For coding purposes: "impacted” cerumen is “packed tightly in the outer ear, so much so that the external ear canal is blocked. The ear wax is hard and possibly crusted"

    As far as billing an E&M visit in addition to removal of impacted cerumen, visits by the same physician on the same day as a minor surgery or endoscopy are included in the payment for the procedure, unless a significant, separately identifiable service is also performed. With that being said, I personally don't feel that a RX is the winning factor that determines billing 69210 and an E/M. If there is a significant, separately identifiable service performed in addition to 69210 and documentation supports both, you have a billable claim.

Similar Threads

  1. Wiki 69210 cerumen impaction removal
    By kvandexter in forum ENT/Otolaryngology
    Replies: 20
    Last Post: 09-03-2014, 01:28 PM
  2. Cerumen Impaction
    By dballard2004 in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 08-27-2013, 12:19 PM
  3. Question regarding Cerumen impaction
    By clmoreland in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 02-15-2011, 08:34 AM
  4. Fecal Impaction
    By busydawnis in forum Gastroenterology
    Replies: 1
    Last Post: 03-18-2010, 03:47 PM
  5. 69210 Cerumen Impaction
    By jkint in forum Family Practice
    Replies: 5
    Last Post: 10-01-2009, 04:06 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.