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ICD-10 Guide
ICD-10 CodesH62.43

H62.43

Billable

Otitis externa in other diseases classified elsewhere, bilateral

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

Code Description

ICD-10 H62.43 is a billable code used to indicate a diagnosis of otitis externa in other diseases classified elsewhere, bilateral.

Key Diagnostic Point:

Otitis externa, commonly known as swimmer's ear, is an inflammation of the external auditory canal. When classified under H62.43, it indicates that the condition is bilateral and associated with other diseases that are classified elsewhere in the ICD-10 system. This condition can arise from various underlying health issues, such as eczema, psoriasis, or allergic reactions, which may predispose individuals to infections. Clinical presentation typically includes ear pain, itching, discharge, and sometimes hearing loss. Diagnosis is primarily clinical, supported by patient history and physical examination, including otoscopic evaluation. Management often involves topical antibiotics or antifungal medications, and in some cases, corticosteroids may be prescribed to reduce inflammation. In chronic cases, addressing the underlying condition is crucial for effective treatment. 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

  • Requires understanding of underlying diseases that may cause otitis externa.
  • Bilateral classification necessitates careful documentation.
  • Differentiation from other types of otitis (e.g., otitis media) is essential.
  • Potential for co-morbid conditions complicates coding.

Audit Risk Factors

  • Inadequate documentation linking otitis externa to underlying conditions.
  • Failure to specify bilateral involvement.
  • Misclassification as otitis media or other ear conditions.
  • Lack of follow-up documentation for chronic cases.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed patient history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with ear pain, discharge, and history of skin conditions.

Billing Considerations

Ensure clear documentation of bilateral involvement and any underlying conditions.

Dermatology

Documentation Requirements

Comprehensive skin assessments and treatment plans for underlying skin conditions.

Common Clinical Scenarios

Patients with eczema or psoriasis presenting with ear symptoms.

Billing Considerations

Document the relationship between skin conditions and otitis externa.

Coding Guidelines

Inclusion Criteria

Use H62.43 When
  • According to ICD
  • 10 guidelines, H62
  • 43 should be used when otitis externa is bilateral and associated with other diseases
  • Coders must ensure that the underlying condition is documented and linked to the otitis externa diagnosis

Exclusion Criteria

Do NOT use H62.43 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

Often performed in conjunction with treatment for otitis externa.

Documentation Requirements

Document the reason for cerumen removal and any associated conditions.

Specialty Considerations

Otolaryngologists may frequently perform this procedure in patients with otitis externa.

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 otitis externa, improving the ability to capture the complexity of cases and ensuring appropriate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like otitis externa, improving the ability to capture the complexity of cases and ensuring appropriate 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 difference between otitis externa and otitis media?

Otitis externa affects the external ear canal, while otitis media involves the middle ear. They are coded differently in ICD-10.