Skip to main content

What is CPT 69210?



Removal of cerumen, in simple words removal of ear wax, most of the insurance will not cover for ear wax removal, and all the insurance will deny the procedure stating it is included procedure with office visit. 

following are the Medicare guidelines to bill Removal of cerumen procedure.

·         Cerumen removal is the only reason for the visit.
·         Cerumen removal is performed personally by a physician or midlevel provider.
·         The patient is symptomatic (pain, pressure, poor hearing, etc.) from excessive cerumen.
·         Cerumen removal requires more than drops, cotton swabs, and cerumen spoon.
·         Documentation in the patient record shows that the procedure required significant time and effort.

Medicare will not cover along with the E&M code until above mentioned points are met, still we need bill G0268 for Medicare and 69210 for all other commercial carriers. 

And ICD – 9 (dx) -380.4 code for 69210 along with 25 modifier for office visit.

Comments

  1. UnknownJune 25, 2013 at 12:23 AM

    Nice information and medicare guidelines for cerumen removal. Medical Billing Services is a great medium of interaction of health providers and Insurance companies.
    Thanks for sharing!

    ReplyDelete
  2. UnknownJune 27, 2013 at 8:58 AM

    Medical billing can be a big hassle. Everyone needs to be careful of not getting ripped off. Make sure you know how much you are paying so they don't steal your money.

    Jim | Medical Billing Rochester NY

    ReplyDelete

Post a Comment

Popular posts from this blog

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare  Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria:  Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits.  Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition
7 comments
Read more

Rejection Procedure note qualifier is missing

  Need to check the Charges tab and double click on the Procedure Code line to open up the Charge Entry window. There is a Notes section on the right hand side. If there is a note typed, we need to select the type.   Need to select field and select the appropriate type of note you are sending.   Save the changes made   Check all the procedure if submitted many procedure.   Save the visit again and submit the claim.
Post a Comment
Read more

Mastering the 'Tell Me About Yourself' Interview Question: Best Tips and Examples

In a job interview, the "Tell me about yourself" question is often asked early on and is an opportunity to make a positive first impression. The key is to provide a comprehensive response that highlights your qualifications and aligns with the job you're applying for. Here's a structured approach to crafting the best answer: Start with a Brief Personal Introduction: Begin by mentioning your name and your current or most recent role, if applicable. For example, "I'm [Your Name], and I'm currently working as a Sr AR Specialist at XYZ Company." Provide a Summary of Your Professional Background: Offer a concise overview of your professional journey, emphasizing the experiences and skills most relevant to the position you're interviewing for. You can mention your years of experience, notable career achievements, and areas of expertise. Highlight Relevant Achievements: Share specific accomplishmen
Post a Comment
Read more