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ICD-10 Guide
ICD-10 CodesH70.092

H70.092

Billable

Acute mastoiditis with other complications, left ear

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

Code Description

ICD-10 H70.092 is a billable code used to indicate a diagnosis of acute mastoiditis with other complications, left ear.

Key Diagnostic Point:

Acute mastoiditis is an infection of the mastoid process, typically resulting from an untreated or inadequately treated acute otitis media. This condition is characterized by inflammation and infection of the mastoid air cells, leading to symptoms such as fever, ear pain, and swelling behind the ear. In cases classified under H70.092, the infection has progressed to include other complications, which may involve abscess formation, hearing loss, or the spread of infection to adjacent structures. Clinically, patients may present with otorrhea (ear discharge), tenderness over the mastoid area, and systemic signs of infection. Diagnosis is primarily made through clinical evaluation, supplemented by imaging studies such as CT scans to assess the extent of the disease. Management often requires antibiotic therapy, and in severe cases, surgical intervention such as mastoidectomy may be necessary to drain infected material and prevent further complications. Prompt recognition and treatment are crucial to avoid serious sequelae, including hearing loss or intracranial complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute mastoiditis and other ear infections.
  • Identifying and documenting complications accurately.
  • Understanding the relationship between otitis media and mastoiditis.
  • Navigating the nuances of left vs. right ear coding.

Audit Risk Factors

  • Inadequate documentation of complications.
  • Failure to provide imaging results in the medical record.
  • Misclassification of the ear affected (left vs. right).
  • Lack of clear treatment plans or follow-up notes.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, fever, and swelling behind the ear.

Billing Considerations

Ensure all complications are documented and linked to the diagnosis.

Pediatrics

Documentation Requirements

Thorough history and physical examination, including family history of ear infections.

Common Clinical Scenarios

Children with recurrent ear infections leading to mastoiditis.

Billing Considerations

Consider age-related factors in treatment and documentation.

Coding Guidelines

Inclusion Criteria

Use H70.092 When
  • According to ICD
  • 10 guidelines, H70
  • 092 should be used when there is clear documentation of acute mastoiditis with complications
  • It is important to ensure that the left ear is specified, and any related conditions are coded appropriately

Exclusion Criteria

Do NOT use H70.092 When
  • Exclusion criteria include chronic mastoiditis or cases without complications

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Mastoidectomy, simple

Clinical Scenario

Performed when there is significant infection requiring drainage.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Otolaryngologists must document the extent of the disease and rationale for surgery.

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 acute mastoiditis, improving the accuracy of data collection and reimbursement processes. This specificity helps in tracking outcomes and resource utilization more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like acute mastoiditis, improving the accuracy of data collection and reimbursement processes. This specificity helps in tracking outcomes and resource utilization more effectively.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in tracking outcomes and resource utilization more effectively.

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 are the common complications associated with acute mastoiditis?

Common complications include abscess formation, hearing loss, and the potential spread of infection to adjacent structures, including the brain.