Published: March 29, 2016

Our presidential election

The Democratic and Republican National Conventions are just a couple of months away, and many of us have been riveted by the campaigns, debates, caucuses, and primary elections as the candidates declare who they are and what they can do for us and our country.

Wendy B. Stern, MDWendy B. Stern, MD

By Wendy B. Stern, MD, BOG Immediate Past Chair

The Democratic and Republican National Conventions are just a couple of months away, and many of us have been riveted by the campaigns, debates, caucuses, and primary elections as the candidates declare who they are and what they can do for us and our country. We all understand not only the big picture and significance that lies in the outcome of this presidential election, but also recognize the impact that it will have on healthcare.

I know most of our Members are committed to understanding the candidates, and will participate by voting in the upcoming national elections. I hope that everyone recognizes the parallel importance of our upcoming Academy elections. Like our national elections, whom we elect can make a difference.

The Board of Governors (BOG) serves as your grassroots voice. We represent your interests to our elected leadership through your BOG governors and representatives from your local, state, regional, and specialty societies. Our Academy oversees, influences, institutes, and regulates many behind-the-scenes efforts that impact your everyday ability to provide otolaryngological care. Whether it is the development of guidelines, responding to carrier or scope-of-practice issues, weighing in on the now-repealed SGR physician payment formula, addressing practice management issues, education, or mentoring residents and interns, the mission and strategic goals of our Academy affect us all. All of us have the opportunity to help shape our Academy by participating in the election of our Academy leaders, in addition to the many other volunteer opportunities.

I was privileged to recently serve on the Election Review Task Force, and I learned many interesting facts along the way. Our Academy is one of the most democratically organized national medical societies. Our Academy president, directors-at-large, and Members of the Nominating Committee and Audit Committee are voted into office by you. We have a well-defined system of campaigning to make the elections fair. We have a well-publicized election and easy access to voting. What was discouraging was learning how few of our Members actually vote (typically under 15 percent). Our participation rate is not very different from many other societies, but I know we can do better!

Why wouldn’t you want to help shape the single most important institution to your practice of otolaryngology? In order to do that, start by learning about our current candidates. The BOG traditionally hosts the AAO-HNS president-elect candidates during our spring General Assembly & Candidates Forum (open to the general membership) which is now an important part of the AAO-HNS/F Leadership Forum & BOG Spring Meeting. This past March, many of us gathered in Alexandria, VA, to listen to and meet the candidates. If you didn’t join us this year, come next year! I encourage everyone to read all of our candidates’ statements in this issue of the Bulletin and on our website.

Also, join in the Candidate Forum on ENTConnect! It’s an opportunity to ask the candidates how they would further the strategic goals and mission of the organization, or anything else that’s on your mind. Visit the annual election webpage for details on how you can submit your questions,



More from April 2016 - Vol. 35, No. 03

Correctly coding CPT 69209
For 2016, Current Procedural Terminology (CPT®) code 69209 Removal impacted cerumen using irrigation/lavage, unilateral was created. In order to help otolaryngologist-head and neck surgeons correctly code, the Academy helped the American Medical Association (AMA) draft a CPT Assistant article on the removal of impacted cerumen. In addition to the CPT Assistant article, the Academy’s CPT team has updated the CPT for ENT: Cerumen Removal to further clarify billing 69209 and 69210 Removal impacted cerumen requiring instrumentation, unilateral. The CPT for ENT article can be found at The following are excerpts from the AMA CPT Assistant article “Removal of Impacted Cerumen,” which can be found on page 7 of the January 2016 CPT Assistant, and are reprinted with permission from the AMA: In the CPT 2016 code set, code 69209 was added to the Auditory System subsection to report the removal of impacted cerumen (earwax) using irrigation or lavage. Impacted cerumen was defined in CPT Assistant October 2013, page 14, as having any of the following: Visual considerations: Cerumen impairs exam of clinically significant portions of the external auditory canal, tympanic membrane, or middle ear condition. Qualitative considerations: Extremely hard, dry, irritative cerumen causing symptoms such as pain, itching, hearing loss, etc. Inflammatory considerations: Associated with foul odor, infection, or dermatitis. Quantitative considerations: Obstructive, copious cerumen that cannot be removed without magnification and multiple instrumentations requiring physician skills. 69209 is reported when irrigation and/or lavage is used to remove impacted cerumen. This method uses a continuous flow of liquid (e.g., saline, water) to loosen impacted cerumen and flush it out with or without the use of a cerumen softening agent. Although direct physician work is not required, the removal of cerumen by irrigation or lavage usually takes longer to perform and may require additional staff time and equipment. Only one code (69209 or 69210) may be reported for the primary service provided on the same day on the same ear. Modifier 50, Bilateral Procedure, should be appended if either one of the cerumen removal procedures is performed on both ears. Codes 69209 and 69210 should not be reported together when both services are provided on the same day on the same ear. The appropriate evaluation and management (E/M) code based upon category and site of service (e.g., office or other outpatient, hospital care, nursing facility services) should be reported when non-impacted cerumen is removed. An E/M code may be reported if there is a separate and distinct service performed at the same session. The full article is available to Academy Members at (login required).