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v1.0.0
ICD-10 Guide
ICD-10 CodesH70.81

H70.81

Billable

Postauricular fistula

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

Code Description

ICD-10 H70.81 is a billable code used to indicate a diagnosis of postauricular fistula.

Key Diagnostic Point:

Postauricular fistula is a congenital or acquired abnormal connection between the skin of the postauricular area and the underlying structures, often associated with the ear and mastoid process. This condition can manifest as a small pit or sinus located behind the ear, which may become infected or inflamed, leading to discharge and discomfort. Clinically, patients may present with recurrent infections, pain, or drainage from the fistula, particularly during episodes of otitis media or mastoiditis. Diagnosis typically involves a thorough clinical examination, imaging studies such as CT scans to assess the extent of the fistula, and possibly cultures of any discharge to rule out specific pathogens. Management may include surgical intervention to excise the fistula, especially if recurrent infections occur. Postauricular fistulas can be associated with other ear anomalies, and thus, a comprehensive evaluation of the ear and surrounding structures is essential for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Potential association with other ear conditions
  • Need for imaging studies for accurate diagnosis
  • Surgical intervention may vary based on individual anatomy

Audit Risk Factors

  • Inconsistent documentation of symptoms and treatment history
  • Failure to document imaging studies that support diagnosis
  • Inadequate detail on surgical procedures performed
  • Misclassification of the condition as a simple ear infection

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of ear infections, physical examination findings, imaging results, and surgical notes.

Common Clinical Scenarios

Patients presenting with recurrent postauricular infections or drainage, requiring surgical evaluation.

Billing Considerations

Ensure all relevant imaging and surgical details are documented to support coding.

Pediatrics

Documentation Requirements

History of ear infections, family history of congenital anomalies, and developmental milestones.

Common Clinical Scenarios

Children with recurrent ear infections and associated postauricular fistulas.

Billing Considerations

Document any developmental concerns or associated syndromes.

Coding Guidelines

Inclusion Criteria

Use H70.81 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's nature, associated symptoms, and any surgical interventions
  • Include relevant history of recurrent infections or complications

Exclusion Criteria

Do NOT use H70.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69433CPT Code

Mastoidectomy

Clinical Scenario

Performed in cases of chronic infection associated with postauricular fistula.

Documentation Requirements

Detailed operative report and pre-operative imaging.

Specialty Considerations

Otolaryngology specialists should ensure all relevant findings are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ear conditions, including postauricular fistula, improving the accuracy of diagnosis and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, including postauricular fistula, improving the accuracy of diagnosis and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ear conditions, including postauricular fistula, improving the accuracy of diagnosis and treatment tracking.

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 postauricular fistula?

Common symptoms include recurrent drainage, pain, and swelling in the postauricular area, often exacerbated by infections.