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69210 and 92587

  1. #1
    Default 69210 and 92587
    Exam Training Packages
    are these codes bundled? I have an edit, however, not finding this in the CPT professional.

    thanks

  2. #2
    Default
    Quote Originally Posted by gcohen View Post
    are these codes bundled? I have an edit, however, not finding this in the CPT professional.

    thanks
    I just plunked this into EncoderPro, and it says, "Code 92587 (column 1) has a CCI conflict with code 69210 (column 2). A modifier is not allowed to override this relationship." The reason given is, "Misuse of column two code with column one code."
    Tami
    CPC, CDEO, CPEDC

  3. #3
    Default
    Payers have policies that go more in depth than CPT. NCCI doesnt even allow bypassing this combo with a modifier. Removal of wax is inclusive to the hearing test.

    From the NCCI manual:

    Removal of cerumen by an audiologist prior to audiologic function testing is not separately reportable. If the cerumen is impacted, cannot be removed by the audiologist, and requires removal by a physician, the physician may report HCPCS code G0268 (Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing). The physician shall not report CPT code 69209 (removal of impacted cerumen using irrigation/lavage, unilateral) or 69210 (removal of impacted cerumen requiring instrumentation, unilateral) for this service.
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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