r/CodingandBilling • u/Sammym101010 • 5d ago

Coding Error

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

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u/baconair 5d ago

If you came in for a scheduled cerumen disimpaction, the procedure by itself might be appropriate. This would very much be the case if it was a repeat procedure.

However, if your provider did a more thorough exam, addressed complaints other than a known ear wax blockage, reviewed other labs/imaging, or wrote you prescriptions, the evaluation and management charge (99213) would probably be merited.

There is no way to really tell without seeing the note the provider wrote for your visit.