It's ok to bill the 93000 with the Pe, just place a -25 on the 99385, and make sure you have the physician's interpretation/report to bill the global EKG (not just the strip).
Billing the cerumen removal depends on the situation. If the patient presented with acute/chronic cerumen impaction, and the provider used a cerumen spoon or other instrument to remove it (lavage doesn't count), then you can bill it as long as it wasn't removed only so that the provider could view the tympanic membranes during the exam. The provider should document impaction, and the fact that it was bothersome, not just that it needed to be removed to complete the physical. This shows medical necessity.
If you can also bill the 69210, place the -59 on the 93000.
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