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ICD-10 Guide
ICD-10 CodesH68.129

H68.129

Billable

Intrinsic cartilagenous obstruction of Eustachian tube, unspecified ear

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

Code Description

ICD-10 H68.129 is a billable code used to indicate a diagnosis of intrinsic cartilagenous obstruction of eustachian tube, unspecified ear.

Key Diagnostic Point:

Intrinsic cartilaginous obstruction of the Eustachian tube refers to a blockage within the cartilaginous portion of the Eustachian tube, which connects the middle ear to the nasopharynx. This obstruction can lead to various complications, including fluid accumulation in the middle ear, impaired ventilation, and potential hearing loss. Patients may present with symptoms such as ear fullness, discomfort, hearing impairment, and recurrent otitis media. Diagnosis typically involves a thorough clinical examination, including otoscopy, tympanometry, and possibly imaging studies to assess the Eustachian tube's patency. Management may include medical therapies such as decongestants, nasal corticosteroids, or antihistamines, and in some cases, surgical interventions like Eustachian tube balloon dilation or tympanostomy tubes may be indicated to alleviate symptoms and restore normal ear function.

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 concurrent conditions affecting coding
  • Documentation requirements for surgical interventions

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the affected ear when applicable
  • Misuse of unspecified codes leading to potential denials
  • Inconsistent coding of concurrent ear conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes on patient history, examination findings, and treatment plans are essential. Documentation should include specific symptoms, duration, and any prior treatments.

Common Clinical Scenarios

Patients presenting with recurrent otitis media, chronic ear pain, or hearing loss due to Eustachian tube dysfunction.

Billing Considerations

Ensure that all relevant diagnostic tests and imaging studies are documented to support the diagnosis and any surgical interventions.

Allergy and Immunology

Documentation Requirements

Documentation should include allergy testing results, treatment plans for allergic rhinitis, and any correlation with Eustachian tube dysfunction.

Common Clinical Scenarios

Patients with allergies presenting with Eustachian tube obstruction symptoms.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use H68.129 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used appropriately based on the clinical documentation
  • Include any relevant symptoms and associated conditions to support the diagnosis

Exclusion Criteria

Do NOT use H68.129 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Tympanostomy, general anesthesia

Clinical Scenario

Used in cases where Eustachian tube dysfunction leads to recurrent otitis media requiring surgical intervention.

Documentation Requirements

Document the indication for surgery, including the frequency of ear infections and prior treatments.

Specialty Considerations

Otolaryngologists should ensure that all pre-operative evaluations are documented.

31295CPT Code

Endoscopic balloon dilation of Eustachian tube

Clinical Scenario

Indicated for patients with persistent Eustachian tube dysfunction despite medical management.

Documentation Requirements

Document the patient's history of symptoms and previous treatments.

Specialty Considerations

Ensure that the procedure's necessity is clearly outlined in the clinical notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Eustachian tube disorders, improving the accuracy of diagnoses and treatment tracking. H68.129 provides a clear designation for intrinsic obstruction, facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Eustachian tube disorders, improving the accuracy of diagnoses and treatment tracking. H68.129 provides a clear designation for intrinsic obstruction, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery
  • •
    Centers for Medicare & Medicaid Services (CMS)

Coding & Billing References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery
  • •
    Centers for Medicare & Medicaid Services (CMS)

Frequently Asked Questions

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

Common symptoms include ear fullness, discomfort, hearing loss, and recurrent ear infections. Patients may also experience a sensation of pressure in the ear.

How is intrinsic cartilaginous obstruction diagnosed?

Diagnosis typically involves a clinical examination, tympanometry, and possibly imaging studies to assess the Eustachian tube's patency and rule out other conditions.

What treatment options are available for this condition?

Treatment may include medical management with decongestants and nasal corticosteroids, or surgical options such as Eustachian tube balloon dilation or tympanostomy tubes, depending on the severity of symptoms.