Ear Canal Debridement…Again

Question:

What CPT code would I use for a debridement of purulent debris from the ear canal, with or without placement of a wick in, such as when the patient has Swimmer’s ear? One of my colleagues told me he bills cerumen removal (69210) because there is always a little bit of cerumen mixed in the debris. I thought I’d better check on that.

Answer:

Good idea to check! CPT 69210 (Removal impacted cerumen requiring instrumentation, unilateral) requires the cerumen be impacted and the diagnosis should be 380.4 (Impacted cerumen). If the diagnosis is really Swimmer’s ear and there is “a little bit” of cerumen, then it doesn’t seem right to use 69210 with a diagnosis of 380.4. There is not a CPT code for ear canal debridement for Swimmer’s ear. This service is considered part of the E&M code you will report for that visit. However, if you used the microscope for the diagnosis and treatment then you could also report 92504 (Binocular microscopy (separate diagnostic procedure)).

*This response is based on the best information available as of 01/22/15.