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v1.0.0
ICD-10 Guide
ICD-10 CodesH61.199

H61.199

Billable

Noninfective disorders of pinna, unspecified ear

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

Code Description

ICD-10 H61.199 is a billable code used to indicate a diagnosis of noninfective disorders of pinna, unspecified ear.

Key Diagnostic Point:

H61.199 refers to noninfective disorders affecting the pinna (the outer ear) of an unspecified ear. These disorders can include a variety of conditions such as congenital malformations, trauma, or inflammatory processes that do not involve infection. Clinical presentations may vary widely, including deformities, skin lesions, or changes in the shape and structure of the pinna. Patients may present with symptoms such as pain, discomfort, or cosmetic concerns. Diagnostic criteria typically involve a thorough physical examination, patient history, and may include imaging studies if structural abnormalities are suspected. Management strategies can range from conservative approaches, such as topical treatments for skin conditions, to surgical interventions for significant deformities or trauma. Accurate coding is essential for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of noninfective conditions that can affect the pinna
  • Need for precise documentation to differentiate from infectious disorders
  • Potential for overlapping symptoms with other ear conditions
  • Variability in clinical presentation and management strategies

Audit Risk Factors

  • Inadequate documentation of the specific disorder affecting the pinna
  • Failure to differentiate between infective and noninfective conditions
  • Lack of supporting clinical evidence for the diagnosis
  • Improper linkage between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed examination findings, patient history, and treatment plans.

Common Clinical Scenarios

Patients presenting with deformities, trauma, or chronic skin conditions of the pinna.

Billing Considerations

Ensure clear documentation of the nature of the disorder and any surgical interventions performed.

Dermatology

Documentation Requirements

Photographic evidence of skin lesions, detailed descriptions of lesions, and treatment responses.

Common Clinical Scenarios

Management of skin disorders affecting the pinna, such as eczema or psoriasis.

Billing Considerations

Document the specific characteristics of skin lesions to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use H61.199 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • 199 should be used when the specific nature of the noninfective disorder is not specified

Exclusion Criteria

Do NOT use H61.199 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69300CPT Code

Excision, pinna lesion

Clinical Scenario

Used when excising a lesion on the pinna due to a noninfective disorder.

Documentation Requirements

Document the size, location, and type of lesion excised.

Specialty Considerations

Otolaryngologists should ensure clear linkage between the diagnosis and the procedure performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ear disorders, improving the ability to capture the nuances of noninfective conditions like those represented by H61.199.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear disorders, improving the ability to capture the nuances of noninfective conditions like those represented by H61.199.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ear disorders, improving the ability to capture the nuances of noninfective conditions like those represented by H61.199.

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

When should I use H61.199?

Use H61.199 when documenting noninfective disorders of the pinna when the specific nature of the disorder is not specified in the medical record.