February 18, 2016

Question:
Someone told me to bill an E/M code like 99212 or 99202, instead of 69210 when removing impacted cerumen with instrumentation. What do you think?

Answer:
Absolutely not! The ICD-10-CM code for cerumen impaction (H61.20 – H62.23) supports reporting a CPT code for the removal (69210). Also, Medicare’s payment for 69210 is higher than the payment for 99212 so you’d be losing money if you did that. You’re supposed to code for what you do which means 69210 is the correct code to report.

*This response is based on the best information available as of 02/18/16.