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ICD-10 Guide
ICD-10 CodesH81.01

H81.01

Billable

Ménière's disease, right ear

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

Code Description

ICD-10 H81.01 is a billable code used to indicate a diagnosis of ménière's disease, right ear.

Key Diagnostic Point:

Ménière's disease is a chronic inner ear disorder characterized by episodes of vertigo, tinnitus, hearing loss, and a sensation of fullness in the affected ear. In the case of H81.01, the condition specifically affects the right ear. The pathophysiology involves an abnormal accumulation of endolymphatic fluid in the inner ear, leading to increased pressure and subsequent damage to the cochlea and vestibular system. Clinically, patients may experience sudden attacks of vertigo that can last from 20 minutes to several hours, fluctuating hearing loss that may become permanent over time, and persistent tinnitus. Diagnosis is typically made based on clinical history, audiometric testing, and exclusion of other conditions. Management may include dietary modifications, diuretics, vestibular rehabilitation, and in some cases, surgical interventions such as endolymphatic sac decompression or vestibular nerve section. Accurate coding is essential for proper reimbursement and tracking of this complex condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptom severity
  • Need for comprehensive documentation of symptoms and treatment response
  • Potential for co-morbid conditions affecting the ear
  • Differentiation from other vestibular disorders

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment plans
  • Failure to document the right ear specifically
  • Misdiagnosis or coding of related conditions
  • Lack of follow-up documentation for chronic conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of symptoms, audiometric test results, and treatment plans.

Common Clinical Scenarios

Patients presenting with recurrent vertigo, tinnitus, and hearing loss.

Billing Considerations

Ensure documentation reflects the episodic nature of symptoms and any interventions performed.

Neurology

Documentation Requirements

Neurological assessments, imaging studies if applicable, and differential diagnosis considerations.

Common Clinical Scenarios

Patients with vestibular symptoms requiring neurological evaluation.

Billing Considerations

Document any neurological findings that may differentiate Ménière's disease from other vestibular disorders.

Coding Guidelines

Inclusion Criteria

Use H81.01 When
  • Follow the official ICD
  • CM coding guidelines for coding diseases of the ear
  • 01 should be used when the right ear is specifically affected, and documentation must support the diagnosis and any associated symptoms

Exclusion Criteria

Do NOT use H81.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Endolymphatic sac decompression

Clinical Scenario

Used for patients with intractable Ménière's disease symptoms.

Documentation Requirements

Document the indication for surgery and pre-operative evaluations.

Specialty Considerations

Otolaryngology specialists should ensure all surgical notes reflect the diagnosis and procedural details.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Ménière's disease, improving the ability to track and manage this condition. The granularity of ICD-10 codes helps in understanding the prevalence and treatment outcomes of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Ménière's disease, improving the ability to track and manage this condition. The granularity of ICD-10 codes helps in understanding the prevalence and treatment outcomes of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Ménière's disease, improving the ability to track and manage this condition. The granularity of ICD-10 codes helps in understanding the prevalence and treatment outcomes of the disease.

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 treatments for Ménière's disease?

Common treatments include dietary changes (low-salt diet), diuretics, vestibular rehabilitation, and in some cases, surgical options like endolymphatic sac decompression.