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ICD-10 Guide
ICD-10 CodesH61.89

H61.89

Billable

Other specified disorders of external ear

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

Code Description

ICD-10 H61.89 is a billable code used to indicate a diagnosis of other specified disorders of external ear.

Key Diagnostic Point:

H61.89 encompasses a variety of disorders affecting the external ear that do not fall under more specific categories. This includes conditions such as external ear infections (otitis externa), cerumen impaction, and other less common disorders like perichondritis or auricular hematoma. Clinical presentation may vary widely, with symptoms including pain, itching, discharge, and hearing loss. Diagnostic criteria often involve a thorough history and physical examination, possibly supplemented by audiometric testing or imaging studies to rule out other conditions. Management typically includes conservative measures such as ear cleaning, topical antibiotics, or corticosteroids, and in some cases, surgical intervention may be necessary to address complications or persistent issues. Accurate coding requires careful documentation of the specific disorder and its clinical implications, as well as any associated treatments.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions included under the code
  • Need for precise documentation to differentiate from similar codes
  • Potential for overlapping symptoms with other ear disorders
  • Variability in treatment approaches based on specific diagnosis

Audit Risk Factors

  • Inadequate documentation of specific ear disorders
  • Failure to link diagnosis with appropriate treatment
  • Misuse of the code for more common conditions
  • Lack of clarity in clinical notes regarding the nature of the disorder

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Management of chronic otitis externa, cerumen impaction, and post-surgical complications.

Billing Considerations

Ensure specificity in documentation to support the use of H61.89 over more specific codes.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings.

Common Clinical Scenarios

Initial evaluation of ear pain, referral for specialist evaluation.

Billing Considerations

Documenting the rationale for referral and any preliminary treatments provided.

Coding Guidelines

Inclusion Criteria

Use H61.89 When
  • According to ICD
  • 10 coding guidelines, H61
  • 89 should be used when the specific disorder of the external ear is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that it is not a more specific condition that has its own code

Exclusion Criteria

Do NOT use H61.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

Used when cerumen impaction is diagnosed and treated.

Documentation Requirements

Document the reason for cerumen removal and any associated symptoms.

Specialty Considerations

Otolaryngologists may perform this procedure in a more complex context.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding ear disorders, but it has also introduced complexity in distinguishing between various conditions that may have overlapping symptoms.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding ear disorders, but it has also introduced complexity in distinguishing between various conditions that may have overlapping symptoms.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding ear disorders, but it has also introduced complexity in distinguishing between various conditions that may have overlapping symptoms.

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 types of conditions are coded under H61.89?

H61.89 is used for various unspecified disorders of the external ear, including infections, cerumen impaction, and other less common conditions that do not have a specific code.