Cerumen Removal Win: Policy Reversed

June 12, 2014 - 3:34pm

After learning from members that Cigna, among other payers, was denying claims when CPT 69210 was billed in conjunction with any office based Evaluation and Management (E/M) CPT code (99211-99215), the Academy sent letters to Cigna disputing its flawed policy. We are pleased to announce that Cigna has now changed this policy such that any claim with modifier 25 that was denied will be reprocessed, and going forward, providers will reimbursed when modifier 25 is appended, with no documentation necessary with submission. MORE