Coding Q & A

I would like to discuss a question I’ve received several times over the past few months:

Question: Most of my insurance companies no longer want to pay for ear irrigation for cerumen impaction. What can I do?

Answer: We also have been having problems getting paid for cerumen removal. Try this: document in the note that the patient had "impacted cerumen" and that it was "manually removed" (like with a curette) "by the physician". If it is done with an office visit, be sure and put a 25 modifier on the office visit. If it is denied then appeal it with a paper claim. If it is still denied then that means it is just their policy to not pay for it.

Many people get denied this because of those above 3 requirements. It must be impacted cerumen and not just ear wax. It must be manually removed and not just flushed out with water. And it must be done by the provider, not the nurse.

Advanced Coding Strategies

We have received a very positive response about our upcoming Advanced Coding Strategies Seminar. Here are the details: It will be held on Saturday October 15th from 8:00am to noon in Dallas at The Courtyard Dallas Central Expressway. The cost will be $250 and you are invited to come participate, or if unable you may order the audio and video materials which will be available by October 25. We hope the positive response will translate into a nice crowd at meeting time. We are utilizing a smaller venue for this initial course and seating will be limited.

More details will be available on the website and in the next few newsletters (the course is available on our website now). This course is intended to be a part 2 or ‘graduate’ coding course. It is intended for those of you that have already taken our basic Coding Growth Strategies course. We will give a simple overview of coding and then dive in to the many challenging cases that we are presented with in our typical daily practice. You’ve heard me say that “90% of the time if you find out the level of Risk, you then know how to code for the service.” This class goes in depth to the other 10% of the time.

One thing I’m very excited about is the "Challenging Cases" section. All attendees will be encouraged to submit 1-2 of their most difficult (or common) coding challenges. These will be printed and distributed to the group then as a group we will go through and pick them apart to see exactly the correct coding that should be applied to the note. And as always, if anything was overlooked we will definitely show where an additional piece of documentation could’ve made the difference for a higher level of service.

Sign up for the Advanced Coding Strategies live presentation

Pre-order the Advanced Coding Strategies DVD/CD (available October 25)