Removal of Impacted Ear Wax: Claim Submission Information

This article provides instructions on the correct claim submission of CPT® code 69210 (removal of impacted ear wax) when the service is performed bilaterally. The AMA’s CPT Coding Manual description for CPT® code 69210 describes this CPT® code as a unilateral procedure and also indicates this CPT® code may be submitted with the Modifier 50 when the service is performed bilaterally.

The CMS Medicare Physician Fee Schedule Database (MPFSDB) indicates a bilateral indicator of 2 for CPT® code 69210. A bilateral indicator of "2" signifies the service for Medicare purposes, is a bilateral procedure and the MPFSDB allowance is based on the service being performed bilaterally. Therefore, for Medicare purposes, CPT® code 69210 should be submitted as follows when performed bilaterally:

• Submit CPT® code 69210 with one unit of service and no modifiers
• Do not submit CPT® modifier 50 or multiple units

Claims submitted with CPT® code 69210 and the modifier 50 or multiple units of service will be returned as unprocessable using claim adjustment reason code MA130. Rejected claims must be corrected and resubmitted. CMS reserves the right to change the MPFSDB bilateral indicator in the future. Providers are encouraged to review the MFSDB for any future changes.

See the Medicare Physician Fee Schedule Part B for more information.