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What does CPT 69210 mean?
Distinguish Bilateral Procedures CPT® identifies 69210 as a unilateral procedure. If the provider removes impacted cerumen from both the right and left ears, you may report a bilateral procedure.
What is the difference between code 99203 and 69210?
To report this patient encounter, the physician appends Modifier ‘-25’ to code 99203, and separately reports code 69210 … to indicate that both a significant E/M service and a procedure were performed on a given day.
Do I need a 59 modifier for a 69210 code?
No 59 modifier required. Hope it helps…. 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.
What are the documentation requirements for 69210?
Documentation Requirements for 69210 To ensure proper reporting of 69210, documentation in the medical record should ideally include: Location of impacted cerumen (left ear, right ear, or bilateral) Instrumentation and/or magnification used, including otoscope and/or operating microscope
What is the CPT code for a bilateral procedure?
For many payers, a bilateral procedure may be reported using a single unit of 69210, with modifier 50 Bilateral procedure appended, as indicated in the CPT® 2014 codebook. Note, however, that the 2014 Medicare National Physician Fee Schedule Relative Value File assigns 69210 a “2” bilateral indicator.
Is cerumen removal 69210 a unilateral procedure?
Because the CPT Manual describes the procedure as inherently unilateral, each instance of 69210 would be billed on a separate claim line with applicable modifiers. Keep in mind: Although CPT guidelines clearly state that a surgical cerumen removal is a unilateral procedure, many payers have their own policies that contradict CPT guidance.