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ICD-10 Guide
ICD-10 CodesH91.1

H91.1

Billable

Presbycusis

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

Code Description

ICD-10 H91.1 is a billable code used to indicate a diagnosis of presbycusis.

Key Diagnostic Point:

Presbycusis is a type of age-related hearing loss that typically affects older adults. It is characterized by a gradual decline in hearing ability, particularly in the higher frequency ranges. The condition is caused by a combination of factors including changes in the inner ear structures, auditory nerve degeneration, and alterations in the central auditory pathways. Patients often report difficulty understanding speech, especially in noisy environments, and may experience a sensation of fullness in the ears. The onset is usually insidious, making it challenging to recognize initially. Diagnosis is primarily clinical, supported by audiometric testing that reveals a characteristic pattern of hearing loss. Management may include hearing aids, auditory rehabilitation, and counseling to help patients adapt to their hearing loss. It is essential for healthcare providers to differentiate presbycusis from other types of hearing loss, such as noise-induced or conductive hearing loss, to ensure appropriate treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of hearing loss
  • Age-related nuances in clinical presentation
  • Variability in patient reporting and symptom recognition
  • Need for audiometric testing documentation

Audit Risk Factors

  • Inadequate documentation of audiometric findings
  • Failure to differentiate from other hearing loss types
  • Lack of patient history regarding onset and progression
  • Insufficient detail on management strategies

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric results, patient history, and management plans.

Common Clinical Scenarios

Evaluation of elderly patients with gradual hearing loss, fitting of hearing aids.

Billing Considerations

Ensure comprehensive documentation of all assessments and interventions.

Audiology

Documentation Requirements

Complete audiological evaluations, including pure tone audiometry and speech recognition scores.

Common Clinical Scenarios

Routine hearing assessments in older adults, rehabilitation counseling.

Billing Considerations

Document the impact of hearing loss on daily activities and quality of life.

Coding Guidelines

Inclusion Criteria

Use H91.1 When
  • According to ICD
  • 10 guidelines, presbycusis is classified under diseases of the ear and mastoid process
  • It is essential to document the patient's age, onset of symptoms, and results from audiometric testing to support the diagnosis

Exclusion Criteria

Do NOT use H91.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used during the evaluation of a patient suspected of presbycusis.

Documentation Requirements

Complete audiometric results and patient history.

Specialty Considerations

Otolaryngologists and audiologists must ensure thorough documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of presbycusis, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other types of hearing loss.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of presbycusis, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other types of hearing loss.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other types of hearing loss.

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 is the primary cause of presbycusis?

Presbycusis is primarily caused by age-related changes in the inner ear structures and auditory pathways, leading to a gradual decline in hearing ability.