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ICD-10 Guide
ICD-10 CodesH61.12

H61.12

Billable

Hematoma of pinna

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

Code Description

ICD-10 H61.12 is a billable code used to indicate a diagnosis of hematoma of pinna.

Key Diagnostic Point:

Hematoma of the pinna, commonly referred to as an auricular hematoma, occurs when blood collects between the cartilage and the skin of the outer ear due to trauma or injury. This condition is often seen in individuals who participate in contact sports, such as wrestling or boxing, where blunt force trauma can lead to the separation of the skin from the underlying cartilage. Clinically, patients may present with a swollen, tender ear that may appear red or bruised. If left untreated, the hematoma can lead to complications such as infection or deformity of the ear, commonly known as 'cauliflower ear.' Diagnosis is typically made through physical examination, and imaging may be utilized in cases where the extent of the hematoma is unclear. Management usually involves drainage of the hematoma to prevent complications, along with compression dressings to minimize recurrence. In some cases, surgical intervention may be necessary to repair any underlying damage to the ear structure. Proper coding for this condition is essential to ensure accurate billing and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of ear anatomy and related conditions.
  • Differentiation from other ear conditions such as infections or tumors.
  • Need for accurate documentation of trauma history.
  • Potential for complications that may require additional coding.

Audit Risk Factors

  • Inadequate documentation of the cause of the hematoma.
  • Failure to document treatment provided.
  • Misclassification of the hematoma as an infection.
  • Lack of follow-up documentation post-treatment.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and treatment plan.

Common Clinical Scenarios

Management of auricular hematomas in athletes, post-surgical complications, and chronic ear deformities.

Billing Considerations

Ensure documentation reflects the urgency of treatment to prevent complications.

Sports Medicine

Documentation Requirements

In-depth history of the injury, including sport-specific details and physical examination results.

Common Clinical Scenarios

Acute management of ear injuries in athletes, including drainage procedures.

Billing Considerations

Documenting the impact of the injury on the athlete's performance and recovery.

Coding Guidelines

Inclusion Criteria

Use H61.12 When
  • Follow official ICD
  • CM guidelines for coding injuries, ensuring accurate documentation of the cause and treatment
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use H61.12 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 drainage of hematoma if cerumen is present.

Documentation Requirements

Document the presence of cerumen and the need for removal.

Specialty Considerations

Otolaryngologists should note any additional findings during the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like hematoma of the pinna, improving the accuracy of billing and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like hematoma of the pinna, improving the accuracy of billing and treatment tracking.

Reimbursement & Billing Impact

billing and treatment tracking.

Resources

Clinical References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Coding & Billing References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Frequently Asked Questions

What is the primary cause of a hematoma of the pinna?

The primary cause is trauma to the ear, often seen in contact sports or accidents.

How is a hematoma of the pinna treated?

Treatment typically involves drainage of the hematoma and application of a compression dressing to prevent recurrence.

What are the potential complications of an untreated hematoma of the pinna?

Complications can include infection, deformity of the ear, and chronic pain.

When should a hematoma of the pinna be surgically treated?

Surgical intervention may be necessary if the hematoma is large, recurrent, or associated with significant deformity.