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ICD-10 Guide
ICD-10 CodesH72.819

H72.819

Billable

Multiple perforations of tympanic membrane, unspecified ear

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

Code Description

ICD-10 H72.819 is a billable code used to indicate a diagnosis of multiple perforations of tympanic membrane, unspecified ear.

Key Diagnostic Point:

Multiple perforations of the tympanic membrane, commonly referred to 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), tinnitus, and a sensation of fullness in the ear. The tympanic membrane serves as a barrier to protect the middle ear from pathogens and external elements; thus, perforations can lead to recurrent infections and complications such as cholesteatoma. 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 effectiveness of treatment. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise documentation of the number and location of perforations
  • Differentiation from other tympanic membrane conditions
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the number of perforations
  • Incorrect linkage of diagnosis to treatment codes
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed otoscopic findings, audiometric results, and treatment plans.

Common Clinical Scenarios

Patients with chronic ear infections, trauma-related perforations, or post-surgical complications.

Billing Considerations

Ensure documentation reflects the severity and impact on hearing for accurate coding.

Audiology

Documentation Requirements

Audiometric evaluations and reports on hearing loss related to tympanic membrane status.

Common Clinical Scenarios

Assessment of hearing loss in patients with known tympanic membrane perforations.

Billing Considerations

Link audiological findings to the diagnosis of tympanic membrane perforation for comprehensive coding.

Coding Guidelines

Inclusion Criteria

Use H72.819 When
  • Follow official ICD
  • 10 guidelines for coding ear conditions, ensuring accurate documentation of the type and extent of tympanic membrane perforations
  • Include any relevant co
  • morbidities and treatment interventions

Exclusion Criteria

Do NOT use H72.819 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

Otolaryngology specialists should ensure accurate coding based on surgical findings.

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 granularity of data for research and treatment outcomes. H72.819 captures the complexity of multiple perforations, which was less distinctly categorized in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, improving the granularity of data for research and treatment outcomes. H72.819 captures the complexity of multiple perforations, which was less distinctly categorized in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, improving the granularity of data for research and treatment outcomes. H72.819 captures the complexity of multiple perforations, which was less distinctly categorized in ICD-9.

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 tympanic membrane perforations?

Common causes include chronic otitis media, trauma, and barotrauma. Each of these conditions can lead to the development of multiple perforations, impacting hearing and increasing the risk of infections.