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ICD-10 Guide
DiagnosesAsymmetric Hearing Loss

Asymmetric Hearing Loss

ICD-10 Coding for Asymmetric Hearing Loss(H90.3, H90.A21)

PRIMARY SPECIALTYOtolaryngology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Asymmetric Hearing Loss?
Essential facts and insights about Asymmetric Hearing Loss

Key Clinical Considerations:

  • Presence of hearing loss that is significantly different between the two ears, typically defined as a difference of 15 dB or more in pure tone average.
  • Audiometric testing results showing asymmetric thresholds across frequencies.
  • Physical examination findings may include otoscopic examination revealing abnormalities in one ear.
  • Imaging findings, such as MRI or CT scans, may show structural abnormalities in the auditory pathway or inner ear.
  • Severity criteria may include mild, moderate, severe, or profound hearing loss as determined by audiometric evaluation.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the degree of hearing loss in each ear, including audiometric test results.
  • Specific terminology such as 'asymmetric hearing loss' or 'unilateral hearing loss' must be used.
  • Examples include documenting the audiogram results and any relevant patient history that supports the diagnosis.
  • Medical necessity must be established through documentation of symptoms and the impact on daily functioning.
  • Quality measures may include documentation of hearing assessments and follow-up care plans.

Coding Guidelines

Usage Guidelines & Examples

  • Use H90.3 for bilateral asymmetric hearing loss and H90.A21 for unilateral hearing loss when the difference in hearing thresholds is significant.
  • Do not use this code for symmetrical hearing loss or when hearing loss is not confirmed by audiometric testing.
  • Compare with H90.0 (Conductive hearing loss) and H90.1 (Sensorineural hearing loss) for more specific types of hearing loss.
  • Common errors include misclassifying the type of hearing loss or failing to document the asymmetry adequately.
  • In complex cases, consider additional codes for underlying conditions contributing to hearing loss.

Code Exclusions

Important Exclusions

  • Excludes conditions such as bilateral symmetric hearing loss and conductive hearing loss without asymmetry.
  • Alternative codes for excluded conditions include H90.0 for conductive hearing loss.
  • Conditions are excluded because they do not meet the criteria for asymmetry in hearing loss.
  • Common mistakes include misdiagnosing bilateral conditions as asymmetric.
  • Related but distinct conditions include sudden sensorineural hearing loss and presbycusis.

Related ICD-10 Codes

Primary Codes
H90.3
Asymmetric hearing loss
H90.A21
Unilateral hearing loss, asymmetric
Ancillary Codes
H93.25
Differential Codes
H90.A21
H90.3
H90.3
when bilateral criteria are met despite asymmetry.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Otolaryngology

Specialty Applications

  • Applies to patients with documented hearing loss that varies between ears.
  • Patient populations include all ages, with particular attention to older adults and those with risk factors such as noise exposure.
  • Clinical settings include outpatient audiology clinics, ENT practices, and inpatient rehabilitation facilities.
  • Specialty-specific applications are relevant in otolaryngology and audiology.
  • Treatment contexts include hearing aids, cochlear implants, and surgical interventions.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with asymmetric hearing loss based on audiometric findings showing a 20 dB difference between ears.'

Template 2

Template: 'Clinical presentation consistent with asymmetric hearing loss including difficulty hearing in one ear.'

Template 3

Template: 'Diagnostic criteria for asymmetric hearing loss met as evidenced by audiogram results showing significant threshold differences.'

Template 4

Template: 'Treatment plan initiated for asymmetric hearing loss with recommendations for hearing aids in the affected ear.'

Template 5

Template: 'Follow-up care for asymmetric hearing loss including monitoring of hearing thresholds and patient-reported outcomes.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include audiometric test results, patient history, and clinical findings supporting the diagnosis.

How does this differ from similar diagnoses?

Asymmetric hearing loss is characterized by a significant difference in hearing thresholds between ears, unlike symmetrical hearing loss.

What are common billing considerations?

Ensure that the diagnosis is clearly documented and supported by audiometric testing to optimize reimbursement.

What procedures are typically associated?

Commonly associated procedures include audiometric evaluations, tympanometry, and imaging studies.

Are there any quality reporting implications?

Quality measures may include tracking hearing assessments and follow-up care for patients with asymmetric hearing loss.