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69210 & 92504

  1. Default 69210 & 92504
    Medical Coding Books
    Can cerumen removal (69210) and mircoscopy (92504) be billed at the same time. If so what would be the scenario in which these two procedures are acceptable to be billed at the same time? Should a Mod 59 be appended to the microscopy? How would the procedure note be considered with complete documentation?

  2. #2
    Location
    Bentonville, Arkansas
    Posts
    18
    Default
    A cerumen removal 69210 (or G0268) & Microscopy 92504 cannot be billed together. The reason is, the Microscopy is used during the Cerumen removal and is commonly available in most, if not all Otolaryngologists offices and insurance companies know this. Most generally you will receive a denal as a non-covered service if the CPT code 92504 is used. I personally do not suggest using a modifier 59 on either code.

    Hope this helps.

  3. #3
    Location
    Columbia, MO
    Posts
    12,841
    Default
    also remember that 69210 is not for an ear irrigation. It must be a procedure performed by the physician using a scoop or a currette. Not for a nurse or physician to irrigate with saline.

    Debra A. Mitchell, MSPH, CPC-H

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