Follow these billing guidelines for removal of impacted cerumen

The removal of cerumen is a procedure that’s different from routine earwax removal. Routine earwax removal is performed to facilitate the ear examination portion of a physical examination.

Blue Cross Blue Shield of Michigan requires that procedure codes *69209, *69210 and G0268 should only be reported for removal of cerumen when all of these statements apply:

• Impacted cerumen, an immovable collection of compressed or hardened earwax in the external ear canal, is symptomatic and can’t be dislodged.
• Treatment requires extensive use of a spoon, loop, suction device or an agent that degrades the earwax for irrigation.
• The procedure requires the personal attention of the physician.
• The removal of the impacted cerumen is the major part of the encounter.

Note: Cleaning earwax from the external ear canal involves removing the soft, brownish, yellow, wax-like secretion of the ceruminous glands of the external auditory canal. It can easily be removed using a spoon, loop or bulb syringe. For this service, the physician typically takes one to two minutes, and the service shouldn’t be reported separately.

Removal of impacted cerumen (*69209, *69210, G0268) will only be considered as medically necessary when reported with a diagnosis of impacted cerumen (ICD-10 H61.20-H61.23) in accordance with the AMA CPT and HCPCS Level II manuals.

Therefore, CPT codes *69209, *69210 or G0268 billed with any other diagnosis will be denied or recovered.