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ICD-10 Guide
ICD-10 CodesH70.099

H70.099

Billable

Acute mastoiditis with other complications, unspecified ear

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

Code Description

ICD-10 H70.099 is a billable code used to indicate a diagnosis of acute mastoiditis with other complications, unspecified ear.

Key Diagnostic Point:

Acute mastoiditis is an infection of the mastoid process, typically resulting from an untreated or inadequately treated middle ear infection (otitis media). This condition can lead to significant complications, including abscess formation, hearing loss, and potential spread of infection to surrounding structures. Clinically, patients may present with symptoms such as ear pain, fever, swelling behind the ear, and drainage from the ear canal. Diagnostic criteria often include a thorough history and physical examination, imaging studies like CT scans to assess the extent of the infection, and possibly tympanocentesis to analyze middle ear fluid. Management typically involves antibiotic therapy, and in severe cases, surgical intervention such as mastoidectomy may be necessary to drain infected material and prevent further complications. Accurate coding of acute mastoiditis with other complications is crucial for appropriate treatment and reimbursement, as it reflects the severity and complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other ear conditions like otitis media
  • Need for detailed documentation of complications
  • Variability in clinical presentation
  • Potential for surgical intervention

Audit Risk Factors

  • Inadequate documentation of complications
  • Failure to specify the ear involved
  • Misclassification of acute vs. chronic mastoiditis
  • Lack of imaging documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, fever, and swelling behind the ear, often following a recent upper respiratory infection.

Billing Considerations

Ensure clear documentation of any surgical interventions and their outcomes.

Pediatrics

Documentation Requirements

Thorough history of ear infections, family history, and developmental milestones.

Common Clinical Scenarios

Children with recurrent otitis media leading to acute mastoiditis.

Billing Considerations

Consider age-related factors in treatment and coding, as children may present differently.

Coding Guidelines

Inclusion Criteria

Use H70.099 When
  • Follow official coding guidelines for acute mastoiditis, ensuring to document any complications and specify the ear involved
  • Include relevant imaging and treatment details to support the diagnosis

Exclusion Criteria

Do NOT use H70.099 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Tympanostomy with tube placement

Clinical Scenario

Often performed in conjunction with treatment for recurrent otitis media leading to mastoiditis.

Documentation Requirements

Document indication for surgery, pre-operative assessment, and post-operative care.

Specialty Considerations

Otolaryngologists should ensure all surgical notes are complete and reflect the complexity of the case.

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 patient records and reimbursement processes.

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 patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 complications associated with acute mastoiditis?

Common complications include hearing loss, abscess formation, and the potential for intracranial infections such as meningitis or brain abscess.