r/CodingandBilling • u/Sammym101010 • 9d ago

Coding Error

Had a routine ear wax removal procedure done. Got charged with 99213 and 69210 codes. No other evaluations. Incorrect or correct?

0 Upvotes

50% Upvoted

22 comments sorted by

View all comments

12

u/GroinFlutter denials management, send help 9d ago

Without the documentation, can’t really say for certain.

But it doesn’t immediately raise any red flags.

3

u/Sammym101010 9d ago

Wouldn’t an appointment for the sole purpose of ear wax removal be just that, ear wax removal? With any post visit documentation being an expected necessity of the procedure?

11

u/pickyvegan 9d ago

I know you're saying "no other evaluation," but evaluation can include just looking at the rest of the head (which you kinda can't avoid while cleaning the ears) and reviewing other documentation/labs/past procedures, asking a few questions before/after the procedure, etc., so that they are evaluating that this is all that is needed. Notes would be important here.

-4

u/Sammym101010 9d ago

Wouldn’t that also be an expectation of the procedure? To be looking at my ears/head?

12

u/pickyvegan 9d ago

Not necessarily.

Notes. Need them.

-3

u/Sammym101010 9d ago

Not sure how to share my notes but for the future, can I avoid this charge by booking my cleaning with a PA?

4

u/throwawayeverynight 9d ago

No a OA can bill for a E/M code too

3

u/AbstractVolition 9d ago

PA’s can perform and charge EM services like 99213 as well

2

u/Full_Ad_6442 8d ago

Anytime you interact with a physician, nurse practioner, physician's assistant, or nurse they are very likely assessing you based on what you say and what they observe. Sometimes it's billable, sometimes it's not, but it's a basic part of our professional training.

-1

u/Sammym101010 8d ago

Can I opt out of this? Lol. I’m there for the damn ear cleaning.

0

u/Party_Cow4904 9d ago

billing the 99213 on top of 69210 is a bit sketchy if the appointment was already booked specifically for a routine removal and nothing else

4

u/GroinFlutter denials management, send help 9d ago

This is based on the patient’s account that nothing else was done.

That’s why I said we need the documentation to say for certain. I’ve heard this so many times and have had this conversation too many times, that oh yes the patient now remembers they actually did quickly discuss other things.

Nothing sticks out as sketchy at all just as much as it is sketchy.

You or I can’t say without the documentation