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ICD-10 Guide
ICD-10 CodesH61.129

H61.129

Billable

Hematoma of pinna, unspecified ear

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

Code Description

ICD-10 H61.129 is a billable code used to indicate a diagnosis of hematoma of pinna, unspecified ear.

Key Diagnostic Point:

Hematoma of the pinna, or auricle, is a localized collection of blood outside of blood vessels, typically resulting from trauma or injury to the ear. This condition can occur in various settings, including sports injuries, falls, or accidents. Clinically, patients may present with swelling, tenderness, and discoloration of the affected ear. The hematoma can lead to complications such as infection or deformity if not treated promptly. Diagnosis is primarily clinical, supported by physical examination findings. Imaging studies are rarely required unless there is suspicion of underlying fractures or other injuries. Management typically involves drainage of the hematoma to prevent complications and restore the normal contour of the ear. In some cases, compression dressings may be applied post-drainage to minimize recurrence. It is essential for healthcare providers to document the mechanism of injury, treatment provided, and any follow-up care to ensure accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the condition.
  • Need for accurate documentation of the mechanism of injury.
  • Potential for complications requiring additional coding.
  • Differentiation from other ear conditions such as infections or tumors.

Audit Risk Factors

  • Inadequate documentation of the cause of the hematoma.
  • Failure to document treatment provided.
  • Lack of follow-up notes indicating resolution or complications.
  • Coding errors related to unspecified versus specified conditions.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Traumatic ear injuries, post-surgical complications, and recurrent hematomas.

Billing Considerations

Ensure accurate coding based on the specific ear affected and any associated injuries.

Emergency Medicine

Documentation Requirements

Comprehensive assessment of the patient's history, mechanism of injury, and immediate treatment provided.

Common Clinical Scenarios

Acute trauma cases presenting with ear swelling and pain.

Billing Considerations

Document all interventions performed in the emergency setting to support coding.

Coding Guidelines

Inclusion Criteria

Use H61.129 When
  • According to ICD
  • 10 coding guidelines, H61
  • 129 should be used when the specific ear is not documented
  • If the right or left ear is specified, the appropriate code (H61
  • 121 or H61
  • 122) should be used
  • It is crucial to document the cause of the hematoma and any treatments provided

Exclusion Criteria

Do NOT use H61.129 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 findings.

Specialty Considerations

Otolaryngologists may perform this procedure frequently.

10060CPT Code

Incision and drainage of abscess

Clinical Scenario

Used when a hematoma becomes infected.

Documentation Requirements

Document the presence of infection and the procedure performed.

Specialty Considerations

Emergency medicine providers may frequently perform this procedure.

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, including hematomas. This specificity aids in better tracking of conditions and outcomes, improving patient care and billing accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, including hematomas. This specificity aids in better tracking of conditions and outcomes, improving patient care and billing accuracy.

Reimbursement & Billing Impact

billing accuracy.

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 a hematoma of the pinna?

The primary cause of a hematoma of the pinna is trauma, which can occur from various activities such as sports, falls, or accidents.

How is a hematoma of the pinna treated?

Treatment typically involves drainage of the hematoma to prevent complications and restore the normal shape of the ear, along with follow-up care to monitor for recurrence.