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ICD-10 Guide
ICD-10 CodesH68.12

H68.12

Billable

Intrinsic cartilagenous obstruction of Eustachian tube

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

Code Description

ICD-10 H68.12 is a billable code used to indicate a diagnosis of intrinsic cartilagenous obstruction of eustachian tube.

Key Diagnostic Point:

Intrinsic cartilagenous obstruction of the Eustachian tube refers to a condition where the cartilaginous portion of the Eustachian tube becomes obstructed due to various intrinsic factors, such as inflammation, edema, or structural abnormalities. This obstruction can lead to impaired ventilation of the middle ear, resulting in negative pressure, fluid accumulation, and potential development of otitis media. Patients may present with symptoms such as ear fullness, hearing loss, tinnitus, and in some cases, balance disturbances. Diagnosis typically involves clinical evaluation, otoscopic examination, and may include audiometric testing to assess hearing loss. Management strategies may range from conservative measures, such as nasal decongestants and autoinflation techniques, to surgical interventions like balloon Eustachian tuboplasty in refractory cases. Understanding the underlying causes and appropriate treatment options is crucial for effective management of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for differential diagnosis with other ear conditions
  • Potential for surgical intervention complicating coding
  • Documentation requirements for chronic versus acute cases

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify acute versus chronic obstruction
  • Misclassification of related conditions (e.g., otitis media)
  • Lack of clear linkage between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with recurrent otitis media, hearing loss, or Eustachian tube dysfunction.

Billing Considerations

Ensure documentation reflects the severity and duration of symptoms to justify interventions.

Allergy and Immunology

Documentation Requirements

Allergy testing results and treatment plans for underlying allergic rhinitis contributing to Eustachian tube dysfunction.

Common Clinical Scenarios

Patients with allergic rhinitis experiencing Eustachian tube obstruction.

Billing Considerations

Documenting the relationship between allergies and Eustachian tube dysfunction is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use H68.12 When
  • According to official coding guidelines, H68
  • 12 should be used when the obstruction is intrinsic and specifically related to the cartilaginous portion of the Eustachian tube
  • It is important to document the clinical findings that support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use H68.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69705CPT Code

Eustachian tube balloon dilation

Clinical Scenario

Used in patients with chronic Eustachian tube obstruction.

Documentation Requirements

Pre-operative assessment and post-operative follow-up notes.

Specialty Considerations

Otolaryngologists should document the rationale for surgical intervention.

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 H68.12, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like H68.12, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Coding & Billing References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Frequently Asked Questions

What are the common symptoms of intrinsic cartilagenous obstruction of the Eustachian tube?

Common symptoms include ear fullness, hearing loss, tinnitus, and sometimes balance disturbances. Patients may also experience recurrent ear infections due to fluid accumulation.