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ICD-10 Guide
ICD-10 CodesH72.81

H72.81

Billable

Multiple perforations of tympanic membrane

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

Code Description

ICD-10 H72.81 is a billable code used to indicate a diagnosis of multiple perforations of tympanic membrane.

Key Diagnostic Point:

Multiple perforations of the tympanic membrane, commonly known as the eardrum, can occur due to various etiologies, including chronic otitis media, trauma, or barotrauma. Clinically, patients may present with symptoms such as hearing loss, otorrhea (ear discharge), and ear pain. The tympanic membrane serves as a barrier protecting the middle ear from pathogens and external elements; thus, perforations can lead to recurrent infections and further complications. Diagnosis typically involves otoscopic examination, which reveals the presence of multiple perforations, and audiometric testing to assess the degree of hearing loss. Management may include medical treatment with antibiotics for infections, surgical interventions such as tympanoplasty to repair the membrane, and audiological rehabilitation for hearing loss. The prognosis varies depending on the underlying cause and the extent of the perforations, with timely intervention often leading to favorable outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of tympanic membrane perforations
  • Understanding the underlying causes (e.g., chronic otitis media vs. trauma)
  • Documenting associated symptoms and complications accurately
  • Navigating coding for related procedures (e.g., tympanoplasty)

Audit Risk Factors

  • Inadequate documentation of the number and size of perforations
  • Failure to link symptoms with the diagnosis
  • Incorrect coding of associated procedures
  • Misinterpretation of the cause of perforation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed otoscopic findings, audiometric results, and treatment plans.

Common Clinical Scenarios

Patients with chronic ear infections, trauma cases, and pre-operative assessments for tympanoplasty.

Billing Considerations

Ensure clear documentation of the cause of perforations and any associated complications.

Audiology

Documentation Requirements

Audiometric evaluations and hearing loss assessments.

Common Clinical Scenarios

Patients presenting with hearing loss secondary to tympanic membrane perforations.

Billing Considerations

Document the impact of perforations on hearing thresholds and rehabilitation plans.

Coding Guidelines

Inclusion Criteria

Use H72.81 When
  • According to ICD
  • 10 guidelines, H72
  • 81 should be used when multiple perforations are documented
  • It is essential to ensure that the clinical documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use H72.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanoplasty

Clinical Scenario

Used for surgical repair of multiple tympanic membrane perforations.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Otolaryngologists should document the extent of perforations and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, improving the accuracy of diagnoses and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, improving the accuracy of diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, improving the accuracy of diagnoses 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 causes of multiple perforations of the tympanic membrane?

Common causes include chronic otitis media, trauma, and barotrauma. Each cause may require different management strategies.