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v1.0.0
ICD-10 Guide
ICD-10 CodesH66.93

H66.93

Billable

Otitis media, unspecified, bilateral

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

Code Description

ICD-10 H66.93 is a billable code used to indicate a diagnosis of otitis media, unspecified, bilateral.

Key Diagnostic Point:

Otitis media is an inflammation or infection of the middle ear, which can occur in one or both ears. The bilateral designation indicates that both ears are affected, although the specific nature of the infection or inflammation is unspecified. This condition is commonly seen in children but can also affect adults. Symptoms may include ear pain, fever, irritability, and hearing loss. Diagnosis typically involves a physical examination, where a healthcare provider may observe fluid in the middle ear or signs of infection. Treatment often includes pain management, antibiotics if a bacterial infection is suspected, and in some cases, surgical interventions such as tympanostomy tubes to facilitate drainage. The unspecified nature of this code means that further specification regarding the type of otitis media (e.g., acute, chronic, or recurrent) is not provided, which can complicate treatment and management decisions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the condition can lead to ambiguity in treatment.
  • Differentiating between acute and chronic otitis media requires careful documentation.
  • Potential for co-existing conditions affecting the ear.
  • Variability in clinical presentation among different patient populations.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to specify the type of otitis media.
  • Lack of follow-up documentation regarding treatment outcomes.
  • Coding without supporting clinical evidence.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes on the patient's history, physical examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with ear pain, drainage, or hearing loss.

Billing Considerations

Ensure clear documentation of the type of otitis media and any surgical interventions performed.

Pediatrics

Documentation Requirements

Thorough history of recurrent ear infections and developmental milestones.

Common Clinical Scenarios

Children with frequent upper respiratory infections leading to otitis media.

Billing Considerations

Document family history and any environmental factors contributing to recurrent infections.

Coding Guidelines

Inclusion Criteria

Use H66.93 When
  • According to ICD
  • 10 guidelines, H66
  • 93 should be used when the specific type of otitis media is not documented
  • Coders should ensure that the bilateral nature is clearly indicated in the medical record

Exclusion Criteria

Do NOT use H66.93 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Tympanostomy, bilateral

Clinical Scenario

Used when surgical intervention is required for recurrent otitis media.

Documentation Requirements

Document indication for surgery, patient history, and pre-operative assessments.

Specialty Considerations

Otolaryngologists should ensure that all criteria for surgery are met and documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of otitis media, which can improve treatment tracking and outcomes. H66.93 provides a broad category for unspecified bilateral cases, which can help in capturing data for epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of otitis media, which can improve treatment tracking and outcomes. H66.93 provides a broad category for unspecified bilateral cases, which can help in capturing data for epidemiological studies.

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

When should I use H66.93?

Use H66.93 when a patient presents with bilateral otitis media, and the specific type is not documented. Ensure that the bilateral nature is clearly indicated in the medical record.