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  1. 1 Ιαν 2016 · General Guidelines for Claims submitted to Part A or Part B MAC: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare.

  2. Billing and reimbursement for CPT code 69210 or HCPCS code G0268 is limited to clinical circumstances where documentation supports these to be reasonable and necessary services requiring a physician's skill.

  3. 1 Μαρ 2021 · For Medicare claims, HCPCS Level II code G0268 Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing is appropriate to report (instead of 69209 or 69210) when the physician or other qualified healthcare practitioner removes impacted cerumen from a patient’s ear(s) on the same date ...

  4. 4 Ιουλ 2023 · Removal of Impacted Ear Wax: Claim Submission Information. This article provides instructions on the correct claim submission of CPT® code 69210 (removal of impacted ear wax) when the service is performed bilaterally.

  5. 1 Σεπ 2014 · In contrast to CPT® instructions, the Centers for Medicare & Medicaid Services (CMS) allows only one unit of 69210 to be billed when furnished bilaterally. In other words: Medicare won’t pay anything extra if you report cerumen removal bilaterally.

  6. Billing guidelines. When billing for CPT code 69210, keep in mind the following guidelines and rules: Code 69210 is a unilateral procedure. If the provider removes impacted cerumen from both ears, follow payer guidelines for reporting a bilateral procedure, such as appending modifier 50 to the code.

  7. Removal of impacted cerumen is reported with CPT code 69210. Chart documentation should include the time, effort, and equipment necessary to provide the service. Because cerumen removal is considered a surgical procedure, it is a non-covered Medicare procedure when performed by an audiologist.

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