60210

My physician did both right and left partial lobectomy. I billed 60210, once for right and once for left as CPT® book stipulates unilateral. Payer denies second/opposite side citing same incision utilized. I believe this to be in error. Payer's coder insists I am interpreting the code incorrectly.

re: 60210

I am not sure about your area payers, however, in Indiana, our payers want us to bill the CPT® code once, add the -50 modifier, and double the price. That's how we get paid for bilateral procedures. Hope this helps...

re: 60210

Try adding a modifier 50-Bilateral procedure to the code 60210 which tells the payer it was a bilateral procedure, that would be the correct way to bill for this procedure:)

re: 60210

Yes, I billed it as bilateral. However, technically this is not a bilateral procedure in the true sense. It more properly would be billed 69210 and 69210-51 (indicating right and left) as I understand it. However, when I called into the payer with my correction I was told it didn't matter which way I wanted to submit the coding, it still is only payable once.

re: 60210

First parenthetical note under 69210 states: for bilateral procedure, report 69210 with modifier -50
Second parenthetical note: for cerumen that is not impacted or does not require instrumentation, code as E/M codes
Procedure description:
69210
Under direct visualization, the physician removes impacted cerumen (ear wax) using a cerumen spoon or delicate forceps. If no infection is present, the ear canal may be irrigated.


I just noticed the subject states 60210 and the discussion is 69210- we are researching 69210?