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v1.0.0
ICD-10 Guide
ICD-10 CodesH70.812

H70.812

Billable

Postauricular fistula, left ear

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

Code Description

ICD-10 H70.812 is a billable code used to indicate a diagnosis of postauricular fistula, left ear.

Key Diagnostic Point:

A postauricular fistula is an abnormal connection or channel that forms behind the ear, typically resulting from developmental anomalies during embryogenesis. This condition can manifest as a small pit or opening in the skin, which may become infected or lead to the accumulation of fluid. In the case of a left ear postauricular fistula, the abnormality is localized to the left side. Patients may present with recurrent infections, drainage, or discomfort in the area. Diagnosis is often made through clinical examination, and imaging studies such as ultrasound or CT scans may be utilized to assess the extent of the fistula and any associated complications. Management typically involves surgical intervention to excise the fistula and prevent recurrence, especially if the patient experiences frequent infections or other complications. Postoperative care is crucial to ensure proper healing and to monitor for any signs of recurrence or infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for imaging studies for accurate diagnosis
  • Potential for associated complications requiring additional coding
  • Differentiation from other ear conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document imaging studies performed
  • Lack of detailed surgical notes post-intervention
  • Misclassification of the condition as a simple ear infection

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including history, physical examination findings, imaging results, and surgical notes.

Common Clinical Scenarios

Patients presenting with recurrent ear infections, drainage from the ear, or complications from previous surgeries.

Billing Considerations

Ensure accurate documentation of the fistula's characteristics and any associated conditions to support the coding.

Pediatrics

Documentation Requirements

Comprehensive history of ear infections, developmental history, and family history of ear conditions.

Common Clinical Scenarios

Children with congenital ear anomalies presenting with postauricular fistulas.

Billing Considerations

Consideration of developmental milestones and potential genetic syndromes associated with ear anomalies.

Coding Guidelines

Inclusion Criteria

Use H70.812 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's specifics
  • Include any relevant imaging studies and surgical interventions in the medical record to support the diagnosis

Exclusion Criteria

Do NOT use H70.812 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69433CPT Code

Excision of postauricular fistula

Clinical Scenario

Used when a patient undergoes surgical excision of a postauricular fistula.

Documentation Requirements

Surgical notes detailing the procedure, indications, and postoperative care.

Specialty Considerations

Otolaryngologists should ensure that all surgical details are documented for accurate coding.

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 postauricular fistula, improving the accuracy of medical records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like postauricular fistula, improving the accuracy of medical records and billing.

Reimbursement & Billing Impact

billing.

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 a postauricular fistula?

Common symptoms include drainage from the fistula, recurrent infections, and discomfort or pain in the area behind the ear.

How is a postauricular fistula diagnosed?

Diagnosis is typically made through clinical examination, and imaging studies such as ultrasound or CT scans may be used to assess the fistula.

What is the treatment for a postauricular fistula?

Treatment usually involves surgical excision of the fistula, especially if the patient experiences recurrent infections or other complications.