Tag Archives: cerumen
Posted on 15. Apr, 2010 by Editor.
Impacted cerumen removal is a fairly straightforward procedure, but billing for the procedure is not always so simple.
The problem: Most payers, including Medicare,consider 69210 (Removal impacted cerumen [separate procedure], one or both ears) to be a minor procedure. But unlike with other minor procedures, they only pay for an E/M service as well as the removal of the impacted cerumen when you have two unrelated diagnoses — one for the E/M service and 380.4 (Impacted cerumen) for the removal of impacted cerumen.
Posted on 10. Sep, 2009 by .
If your PCP is billing 69210 (Removal impacted cerumen [separate procedure], one or both ears), you can bet the auditors will be checking your documentation. If you follow these 3 tips, you can be sure you’re using the code correctly.
1. Check If Wax Is Impacted
The first thing that you need to do is to fully understand the definition of impacted cerumen (384.0). “Remember that 69210 is actually a surgical procedure,” urges Kris Cuddy, CPC, CIMC, independent consultant in DeWitt, Minn.
The American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) says that if any one or more of the following are present, cerumen is considered clinically “impacted”:
• Visual considerations: Cerumen impairs exam of clinically significant portions of the external auditory canal, tympanic membrane, or middle ear condition.
• Qualitative considerations: Extremely hard, dry, irritative cerumen causing symptoms such as pain, itching, hearing loss, etc.
• Inflammatory considerations: Associated with foul odor, infection, or dermatitis.
• Quantitative considerations: Obstructive, copious cerumen that cannot be removed without magnification and multiple instrumentations requiring physician skills.