ICD-10 Coding for Impacted Cerumen Bilateral(H61.23)
Complete ICD-10-CM coding and documentation guide for Impacted Cerumen Bilateral. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Impacted Cerumen Bilateral
H60-H95Primary Range
Diseases of the ear and mastoid process
This range includes conditions related to ear diseases, including impacted cerumen.
Key Information: ICD-10 code for bilateral impacted cerumen
Essential facts and insights about Impacted Cerumen Bilateral
Primary ICD-10-CM Code for impacted cerumen bilateral
Decision Criteria
clinical Criteria
- Bilateral visual obstruction and symptoms
coding Criteria
- Use H61.23 for bilateral cases only
documentation Criteria
- Document specific impaction criteria and removal method
Applicable To
- Bilateral earwax impaction
Excludes
- Otitis externa (H60.-)
Clinical Validation Requirements
- Visual obstruction of tympanic membranes bilaterally
- Symptoms such as hearing loss or otalgia
- Otoscopy confirming impaction
Code-Specific Risks
- Incorrectly coding without meeting impaction criteria
- Using modifier 50 incorrectly with Medicare
Coding Notes
- Ensure documentation specifies bilateral impaction and meets clinical criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Removal of impacted cerumen for audiologic testing
G0268Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Impacted Cerumen Bilateral to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H61.23.
Impact
Clinical: Lack of clarity on patient condition and treatment., Regulatory: Potential for audit issues due to insufficient documentation., Financial: Risk of claim denials or reduced reimbursement.
Mitigation Strategy
Use specific language detailing impaction and removal.
Impact
Reimbursement: Claims may be denied if modifier 50 is used with Medicare., Compliance: Non-compliance with Medicare billing rules., Data Quality: Inaccurate billing data affecting audits and reports.
Mitigation Strategy
Do not use modifier 50 with Medicare; bill 69210 once without the modifier.
Impact
Improper use of modifier 50 with Medicare claims.
Mitigation Strategy
Educate billing staff on payer-specific rules.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Impacted Cerumen Bilateral, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Impacted Cerumen Bilateral
Use these documentation templates to ensure complete and accurate documentation for Impacted Cerumen Bilateral. These templates include all required elements for proper coding and billing.
ENT Clinic Visit for Cerumen Removal
Specialty: OtolaryngologyRequired Elements
- Chief complaint
- Symptoms
- Otoscopy findings
- Procedure details
- Post-procedure findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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