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ICD-10 Guide
ICD-10 CodesH70.90

H70.90

Billable

Unspecified mastoiditis, unspecified ear

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

Code Description

ICD-10 H70.90 is a billable code used to indicate a diagnosis of unspecified mastoiditis, unspecified ear.

Key Diagnostic Point:

Unspecified mastoiditis refers to an inflammatory condition affecting the mastoid process, which is the bony prominence located behind the ear. This condition often arises as a complication of acute otitis media, where infection spreads from the middle ear to the mastoid air cells. Clinical presentation may include ear pain, fever, and swelling behind the ear. Patients may also experience hearing loss due to fluid accumulation or structural changes in the ear. Diagnosis typically involves a thorough clinical examination, imaging studies such as CT scans, and possibly tympanocentesis to assess for infection. Management may include antibiotics, and in severe cases, surgical intervention such as mastoidectomy may be necessary to drain infected material and prevent further complications. The unspecified nature of this code indicates that the specific details of the mastoiditis are not documented, which can complicate treatment and management decisions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in documentation
  • Potential overlap with other ear conditions
  • Variability in clinical presentation
  • Need for imaging studies for accurate diagnosis

Audit Risk Factors

  • Insufficient documentation of clinical findings
  • Failure to specify acute vs. chronic mastoiditis
  • Inadequate justification for surgical interventions
  • Misalignment between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of the relationship between otitis media and mastoiditis.

Pediatrics

Documentation Requirements

Thorough history and physical examination, including developmental milestones and previous ear infections.

Common Clinical Scenarios

Children with recurrent ear infections leading to mastoiditis.

Billing Considerations

Consider age-related factors in treatment and management.

Coding Guidelines

Inclusion Criteria

Use H70.90 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's severity and any associated complications

Exclusion Criteria

Do NOT use H70.90 When
  • Exclude conditions that are more specific to ensure proper coding

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Tympanostomy, bilateral

Clinical Scenario

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

Documentation Requirements

Document indication for tympanostomy and any prior treatments.

Specialty Considerations

Otolaryngologists should ensure clear documentation of the need for surgical intervention.

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, improving the accuracy of diagnoses and treatment plans. However, the unspecified nature of H70.90 can lead to challenges in clinical management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the accuracy of diagnoses and treatment plans. However, the unspecified nature of H70.90 can lead to challenges in clinical management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the accuracy of diagnoses and treatment plans. However, the unspecified nature of H70.90 can lead to challenges in clinical management.

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 symptoms of mastoiditis?

Common symptoms include ear pain, fever, swelling behind the ear, and hearing loss. Patients may also experience drainage from the ear.

When should I use H70.90 instead of a more specific code?

Use H70.90 when the documentation does not specify the type of mastoiditis or when the clinical details are insufficient to assign a more specific code.