Removal of impacted cerumen is commonly performed in many pediatric practices. Because Current Procedural Terminology® provides separate codes for removal of impacted cerumen with and without instrumentation, we must look at 2 different ways of providing and documenting these services.

Code 69209 describes removal of impacted cerumen by irrigation or lavage. This service was valued to include the time of a nurse or medical assistant; supplies such as an ear wash bottle with disposable tip, absorbent pad, cotton swab, emesis basin, or hydrogen peroxide; and use of an otoscope, examination table, and examination light. There is no physician work associated with this service and no post-operative period (ie, 0-day global period).

A physician sees a child with complaint of fever, cough, and runny nose. On examination, the right ear canal is found to be blocked by impacted cerumen. A nurse is instructed to perform irrigation/lavage to remove the impacted...

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