cpt and icd 10 code for ear wax removal

by Kadin Dooley 7 min read

CPT Codes 69209, 69210, G0268
The removal of impacted cerumen (69209, 69210, G0268) is only medically necessary when reported with a diagnosis of impacted cerumen (ICD-10 codes H61. 2–H61. 23) according to the AMA CPT and HCPCS Level II manuals.
Nov 12, 2018

Full Answer

What is the best tool to clean your ears?

Ways to Properly Clean Your Ears

  • Wipe with a Damp Washcloth. While cotton swabs are generally safe to use, there is a tendency for them to push the earwax deeper into the ear canal.
  • Soften the Wax. There are a lot of products in local drugstores to soften the wax. ...
  • Use Syringe. Ear irrigation is also one of the best ways to clean your ears properly. ...

How do you bill for ear wax removal?

Here’s how to use them:

  • Lay sideways: Make sure the ear you’re cleaning faces up and add the drops as directed.
  • Let it sit: Allow the cleaning solution to sit in your ear for around five minutes. This lets the liquid soak in and soften things up.
  • Grab a tissue: When you sit up, the liquid should come out, along with the ear wax that broke loose. ...

Do I need ear wax removal?

Ear wax removal is critical for preventing hearing loss. Ear wax keeps your ear clear of dust and debris that can affect your eardrum, and is supposed to wash out on its own, but sometimes it can become impacted, which can cause hearing loss or ear infections.

Do ear candles actually remove ear wax?

Researchers said ear candling didn't remove earwax from the ear canal. Sometimes, it left candle wax behind in the ear. Some proponents claim ear candling can treat: Sinusitis Sinus pain Tinnitus (ringing in the ears) Vertigo (dizziness) Otitis media (middle ear infection) 2 This is unlikely, though.

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What is the CPT code for removal of ear wax?

CPT code 69210, Removal impacted cerumen, (separate procedure) one or both ears.

What is the ICD 10 code for ear wax?

ICD-10 code H61. 2 for Impacted cerumen is a medical classification as listed by WHO under the range - Diseases of the ear and mastoid process .

How do you bill for ear wax removal?

Removal of impacted cerumen is represented by the following two CPT codes:69209 – Removal impacted cerumen using irrigation/lavage, unilateral.69210 – Removal impacted cerumen requiring instrumentation, unilateral.

What is the difference between CPT code 69209 and 69210?

Like CPT 69210, (removal of impacted cerumen requiring instrumentation, unilateral) 69209 requires that a physician or qualified healthcare professional make the decision to irrigate/lavage. However, unlike 69210, 69209 allows removal to be carried out by clinical staff.

What is the ICD-10 code for Impacted cerumen right ear?

ICD-10-CM Code for Impacted cerumen, right ear H61. 21.

What is cerumen impaction?

Cerumen impaction is defined as an accumulation of cerumen that causes symptoms or prevents assessment of the ear canal, tympanic membrane, or audiovestibular system; complete obstruction is not required. 3.

Can you code 69209 and 69210 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 does CPT code 69210 mean?

removal impacted cerumenCode 69210 is defined as “removal impacted cerumen (separate procedure), one or both ears.” Use this same code only once to indicate that the procedure was performed, whether it involved removal of impacted cerumen from one or both ears.

Is CPT 69210 a bilateral code?

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.

How do I bill CPT 69209?

Reporting 69209 CPT® code 69209 Removal impacted cerumen using irrigation/lavage, unilateral reports removal of impacted cerumen by irrigation and/or lavage.

When do you bill for cerumen removal?

Requirements for reporting 69210: Cerumen is associated with foul odor, infection, or dermatitis; or. Obstructive, copious cerumen of any consistency that cannot be removed without magnification and instrumentation requiring physician skills.

What is procedure code 69209?

We are reporting CPT® code 69209 (removal impacted cerumen using irrigation/lavage, unilateral) for each ear, and the documentation supports the irrigation/lavage rather than the physician removing the impaction with instruments.

General Information

CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

This article gives guidance for billing, coding, and other guidelines in relation to local coverage policy L33945-Cerumen (Earwax) Removal.

ICD-10-CM Codes that Support Medical Necessity

It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM (e.g., to the fourth or fifth digit). The correct use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

What is the CPT code for cerumen removal?

CPT® guidelines tell us, “For cerumen removal that is not impacted, see E/M service code …” such as new or established office patient (99201-99215), subsequent hospital care (99231-99233), etc. In other words: If the earwax isn’t impacted, removal is included in the documented evaluation and management (E/M) service reported and may not be separately billed.#N#Per the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), cerumen is impacted if one or more of the following conditions are present: 1 Cerumen impairs the examination of clinically significant portions of the external auditory canal, tympanic membrane, or middle ear condition; 2 Extremely hard, dry, irritative cerumen causes symptoms such as pain, itching, hearing loss, etc.; 3 Cerumen is associated with foul odor, infection, or dermatitis; or 4 Obstructive, copious cerumen cannot be removed without magnification and multiple instrumentations requiring physician skills.

What is 69210 bilateral?

Both 69209 and 69210 are unilateral procedures . For removal of impacted earwax from both ears, append modifier 50 Bilateral procedure to the appropriate code. In the example above of the 7-year-old child, if irrigation occurred in both ears, appropriate coding is 69209-50.#N#When billing Medicare payers, different bilateral rules apply for 69210. The 2016 Medicare National Physician Fee Schedule Relative Value File assigns 69210 a “2” bilateral indicator. This means, for Medicare payers, the relative value units assigned to 69210 “are already based on the procedure being performed as a bilateral procedure.” In contrast to CPT® instructions, the Centers for Medicare & Medicaid Services (CMS) allows us to report only one unit of 69210 for a bilateral procedure. CMS does allow us to bill a bilateral procedure for cerumen removal by lavage using 69209-50.#N#Finally, note that some payers may stipulate “advanced practitioner skill” is necessary to report removal of impacted earwax (i.e., payers may require that a physician provide 69209, 69210). Query your individual payers to be certain of their requirements.

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