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v1.0.0
ICD-10 Guide
ICD-10 CodesH70.92

H70.92

Billable

Unspecified mastoiditis, left ear

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

Code Description

ICD-10 H70.92 is a billable code used to indicate a diagnosis of unspecified mastoiditis, left ear.

Key Diagnostic Point:

Mastoiditis is an inflammatory condition of the mastoid process, typically resulting from an untreated or inadequately treated middle ear infection (otitis media). The left ear mastoiditis, as denoted by the code H70.92, indicates that the condition is localized to the left mastoid bone. Clinically, patients may present with symptoms such as ear pain, fever, drainage from the ear, and swelling behind the ear. In severe cases, complications can arise, including hearing loss, abscess formation, or intracranial infections. Diagnosis is primarily based on clinical evaluation, supported by imaging studies such as CT scans or MRI to assess the extent of the infection. Management often involves antibiotic therapy, and in some cases, surgical intervention such as mastoidectomy may be necessary to drain infected material and prevent further complications. Accurate coding is essential for proper reimbursement and to reflect the severity of the condition in patient records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic mastoiditis
  • Identifying associated conditions such as otitis media
  • Variability in clinical presentation and severity
  • Need for imaging studies to confirm diagnosis

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document imaging studies
  • Lack of clarity on the relationship between mastoiditis and otitis media
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, fever, and drainage; post-operative follow-ups after mastoid surgery.

Billing Considerations

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

Pediatrics

Documentation Requirements

Thorough history of recurrent ear infections and treatment responses.

Common Clinical Scenarios

Children with recurrent otitis media leading to mastoiditis.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use H70.92 When
  • Follow official ICD
  • CM guidelines for coding mastoiditis, ensuring accurate documentation of the left ear involvement
  • Include any relevant history of otitis media and associated symptoms

Exclusion Criteria

Do NOT use H70.92 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Mastoidectomy, tympanostomy

Clinical Scenario

Used when surgical intervention is required for mastoiditis.

Documentation Requirements

Document the indication for surgery and pre-operative evaluations.

Specialty Considerations

Otolaryngologists must ensure clear documentation of the surgical necessity.

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 mastoiditis, improving the accuracy of patient records and reimbursement processes. H70.92 provides a clear indication of the condition's localization, which is crucial for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like mastoiditis, improving the accuracy of patient records and reimbursement processes. H70.92 provides a clear indication of the condition's localization, which is crucial for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. H70.92 provides a clear indication of the condition's localization, which is crucial for treatment planning.

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 drainage from the ear. Patients may also experience hearing loss.

How is mastoiditis diagnosed?

Diagnosis is typically made through clinical evaluation, supported by imaging studies such as CT scans to assess the extent of the infection.

What treatments are available for mastoiditis?

Treatment often involves antibiotics, and in severe cases, surgical intervention such as mastoidectomy may be necessary.

How does mastoiditis affect hearing?

Mastoiditis can lead to temporary or permanent hearing loss due to the involvement of the middle ear and surrounding structures.