Does CPT code 69210 need a modifier?
When you are using 69210 for ear wax impaction, it is appropriate to use an E/M code (with modifier -25) if the patient received a true evaluation and management for a separate problem (such as bronchitis or pharyngitis) or for complicating problems (such as dizziness or otitis media).
How do I bill Medicare for 69210 bilateral?
A: The coder would report CPT code 69210 (removal impacted cerumen requiring instrumentation, unilateral) with modifier -50 (bilateral procedure) twice. Alternatively, the coder could report code 69210 twice with modifiers -LT (left side) and -RT (right side).
How do you bill for ear wax removal?
If impacted earwax is removed by irrigation or lavage only, use CPT 69209. CPT 69210 should NOT be reported for lavage. obstructive, copious cerumen cannot be removed without magnification and multiple instrumentations requiring physician or non-physician practitioner skills.
Can 69209 and 69210 be billed together?
You may not bill CPT code 69209 with CPT code 69210, “removal impacted cerumen requiring instrumentation, unilateral,” for the same ear. However, CPT codes 69209 and 69210 can be billed for the same encounter if impacted cerumen is removed from one ear using instrumentation and from the other ear using lavage.
What is the correct use of CPT code 69210?
Q.What is the correct use of CPT code 69210 (removal impacted cerumen [separate procedure], one or both ears)? “the removal required physician work using at least an otoscope and instrumentation rather than simple lavage ” [emphasis added].
How to Bill visit 99213-25 with 69210-59?
To start viewing messages, select the forum that you want to visit from the selection below.. We have always billed a visit 99213-25 with 69210-59 to Blue Cross. Recently our claims are denied due to invalid combination of HCPCS modifiers. I can not find a revised edit for a change in these codes/modifiers.
When to use CPT code 99213 and 99202?
Evaluation and Management Codes: New vs Established Clients. Unlike 99212 through 99215, 99202 through 99205 describe newly established clients being seen for evaluation and management services. Code 99213 should only be used with established clients you have already seen for an intake session (CPT Code 90792). Getting Help Billing
Do you need a modifier 59 for 69210?
A modifier 59 is not required since there are no other incidental procedures with 69210 (99214 is not considered a procedure and the immunization is not considered a part of the irrigation) – modifier 25 on the E&M code should be sufficient assuming it is supported by documentation.