tci ED Coding & Reimbursement Alert - 2009 Issue 11

Eye Claims for Cerumen Removal … and a Possible $30 Boost

Earwax treatment always equals E/M ... but sometimes it warrants a procedure, too. Listen up, coders: Patients reporting to the ED for removal of earwax exist on the fault line between ED E/M service and procedure code. Knowing the difference could net you about $30 more per claim. Check out these clues for help making the decision between a procedure code and an E/M on your earwax encounters. Choose E/M If Procedure Isn't a Clinical 'Removal' It might seem like a slam dunk: Patient reports to the ED with earwax, provider removes it, and coder chooses cerumen removal code ... right...

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