69209 Medical Assistant

Can you bill for a 69209 (removal of cerumen using irrigation/lavage) when it is performed by a Medical Assistant? The CPT changes clinical example is for a nurse but my providers feel that it should be able to be billed for when a nurse performs it.


  • edited June 2017
    I have not seen anything that Medicare says it has to be performed by a licensed person - so I don't see a problem with an M.A. doing it.

    Don Self & Associates, Inc

    305 Senter Ave, Whitehouse, TX 75791
    903 871-1172 fax 480-247-5650
    donself@donself.com web: www.donself.com
    books & webinars at https://shop.donself.com

    DISCLAIMER: Don’t read this. It means absolutely nothing. Attorneys and people who think too much of themselves waste their time telling you that if you read something you’re not supposed to, then you’re required by some fictitious law created by an idiot elected by other idiots, but that fictitious law doesn’t exist. I can’t believe you’re still reading this. Email disclaimers mean nothing - but take up space on your screen. So - quit reading this or you will be in violation of USC 501.9103.4 which says nothing because it doesn’t exist either.

    Let me show you how my own Marketing review system works. Complete the data here on this link and within an hour later, check your email or text and you'll see how I get positive reviews and feedback as you will be asked to review us.


  • 69209 is very interesting, because in my notes from 2016 CPT Symposium, the Medicare directors advised it must be a qualified healthcare professional (QHP). However, when I went to the MPFS for more direction, the PC/TC indicator is 5, meaning it's an incident to code. As directly from the MPFS RVU17B PDF, in attachment A:

    "5 = Incident To Codes - This indicator identifies codes that describe services covered incident to a physician's service when they are provided by auxiliary personnel employed by the physician and working under his or her direct personal supervision. Payment may not be made by carriers for these services when they are provided to hospital inpatients or patients in a hospital outpatient department Modifiers 26 and TC cannot be used with these codes."

    My interpretation of the MPFS PC/TC indicator being 5 is if the auxiliary staff are appropriately trained and supervised, they may perform the irrigation and the provider may bill. However, this is only my interpretation and you may want to seek specific health plan/carrier input.

    Hope this helps.


    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292

  • edited June 2017
    I would agree.

  • edited June 2017
    I believe it has to be performed by a physician or Nurse practitioner according to the CMS guidelines.

    Pat Dobbs RN, CPC

  • edited June 2017
    What CMS guidelines?

    There are 0 work RVUs. It is fine to bill if performed by an MA.

  • edited June 2017
    Hi Pat,

    Would you please provide the reference for this from CMS?
    Thank you.

    Siu B. Chu, CPC, CPMA, CEMC
    Sr. Compliance Specialist
    New York University - School of Medicine
    Office of Internal Audit Compliance & Enterprise Risk Management
    1 Park Avenue, 3rd Floor
    New York, New York 10016
    Ph : 212 - 404 – 4083
    Fax: 646-754-5399
    E-mail: siu.chu@nyumc.org

    From: nursedobbs1@aol.com [mailto:nursedobbs1@aol.com]
    Sent: Wednesday, May 17, 2017 2:08 PM
    To: Multiple recipients of list PARTB-L
    Subject: Re: [partb-l] 69209 Medical Assistant

    I believe it has to be performed by a physician or Nurse practitioner according to the CMS guidelines.

    Pat Dobbs RN, CPC

  • I know that medical students have a bad attitude towards linguistics and mathematical disciplines. I recently found a solution. The Internet has given us resources EssayReviewExpert by assistants who can solve our problems. You write an essay and save time

  • If you are writing your dissertation, it means you are approaching the final straight of your academic life. Ts, you still need to know how to write it and we offer the dissertation results section example to make your writing process easy.

  • I can tell you that I was an assistant myself and I know how hard it is. Constantly asked to write a bunch of written works, practice is very little, you have to chisel the theory. But of course there are difficulties to find a good company to help with such works, especially on medical subjects. Few people take up this kind of work. Fortunately, I managed to find a company where I pay to write essay and there were no problems. People were very competent and started doing things quickly. They made even faster deadlines, for which there was a separate reminder. That's why I strongly recommend that you read it. I don't think it would be superfluous. Good luck with that. I hope you did!

  • I really love my work that is the pleasure for me to be a medical assistant and in such a way I can help people who are in need, it is so good to see the smile on the face of the people after their recovery, but the studying process was a disaster for me. The path to becoming a medical assistant typically involves medical assistant training and a certification exam. This process can take between 9 months to 3 years. For me completing the research work was really great challenge, so I used the help of writing service called https://papers-land.com/ papers-land writing service and this platform can definitely recommend to you.

  • I can assure you that I myself have been an assistant and I know how demanding it is. Asked to compose a bunch of written works constantly, practice is so little, the idea must be chiseled. But, of course, finding a good company to help with such work, particularly on medical topics, is difficult. Few individuals take up this kind of task. Luckily, I was able to find a business where I paid to write an essay and there were no issues. People were really professional and soon began doing stuff. They made deadlines much quicker, for which there was a separate alert. That is why I highly encourage you to read it. It would be superfluous, I don't think. With that, good luck. I hope it was you!

  • I can tell you that I was an assistant myself and I know how difficult it is. Asked endlessly to write a bunch of written pieces, preparation is too limited, the concept must be chiseled. But it is difficult, of course, to find a good company to assist with such work, especially on medical topics. Few people take up this sort of assignment https://michaeldadson.com/https://www.michaeldadson.info. Luckily, I was able to find an organization to compose an article where Ihttps://www.gentlecurrentstherapy.com/michael-dadson-clinical-counsellor paid and there were no complications. People were very competent and they quickly started doing things.
    Even sooner, they made targets for which there was a different warning. For this reason, I greatly urge you to read it. That would be, I don't think, superfluous. Good luck with that. It was you, I hope!

Sign In or Register to comment.