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ICD-10 Guide
ICD-10 CodesH61.00

H61.00

Billable

Unspecified perichondritis of external ear

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 H61.00 is a billable code used to indicate a diagnosis of unspecified perichondritis of external ear.

Key Diagnostic Point:

Unspecified perichondritis of the external ear refers to an inflammatory condition affecting the perichondrium, the connective tissue surrounding the cartilage of the ear. This condition can arise from various causes, including trauma, infection, or systemic diseases. Clinically, patients may present with localized pain, swelling, and tenderness of the external ear, often accompanied by erythema. In some cases, there may be drainage of purulent material if an abscess forms. Diagnosis typically involves a thorough clinical examination and may be supported by imaging studies to rule out other conditions. Management often includes antibiotics if an infection is suspected, along with analgesics for pain relief. In severe cases, surgical intervention may be necessary to drain abscesses or remove necrotic tissue. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Potential overlap with other ear conditions such as otitis externa
  • Need for precise documentation to support the diagnosis
  • Differentiation from other inflammatory conditions of the ear

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the cause of perichondritis
  • Misuse of unspecified codes leading to denials
  • Inconsistent coding with surgical interventions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with ear pain, swelling, and potential drainage.

Billing Considerations

Ensure to document any surgical procedures performed and their indications.

Primary Care

Documentation Requirements

Comprehensive patient history and symptom assessment.

Common Clinical Scenarios

Initial evaluation of ear pain or swelling before referral to specialists.

Billing Considerations

Document any systemic symptoms that may indicate a broader condition.

Coding Guidelines

Inclusion Criteria

Use H61.00 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • 00 is used when the specific cause of perichondritis is not documented

Exclusion Criteria

Do NOT use H61.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69200CPT Code

Removal of impacted cerumen

Clinical Scenario

Often performed in conjunction with ear examinations.

Documentation Requirements

Document the reason for cerumen removal and any associated symptoms.

Specialty Considerations

Otolaryngologists may perform this procedure more frequently.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the ability to capture the complexity of cases like perichondritis. This specificity aids in better patient management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the ability to capture the complexity of cases like perichondritis. This specificity aids in better patient management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of perichondritis of the external ear?

Perichondritis can be caused by trauma, infection, or systemic diseases. It is important to identify the underlying cause for appropriate treatment.

How is perichondritis diagnosed?

Diagnosis is primarily clinical, based on the patient's history and physical examination. Imaging may be used to assess the extent of inflammation.

What are the treatment options for perichondritis?

Treatment typically includes antibiotics for infection, analgesics for pain relief, and in severe cases, surgical intervention to drain abscesses.