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ICD-10 Guide
ICD-10 CodesH91.20

H91.20

Billable

Sudden idiopathic hearing loss, unspecified ear

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

Code Description

ICD-10 H91.20 is a billable code used to indicate a diagnosis of sudden idiopathic hearing loss, unspecified ear.

Key Diagnostic Point:

Sudden idiopathic hearing loss (SIHL) is characterized by a rapid onset of hearing loss, typically occurring over a period of 72 hours or less, without an identifiable cause. This condition can affect one or both ears, but in this case, it is unspecified. Patients may present with a range of symptoms including a feeling of fullness in the ear, tinnitus (ringing in the ears), and a noticeable decrease in hearing ability. The etiology of SIHL remains largely unknown, although it may be associated with viral infections, vascular issues, or autoimmune disorders. Diagnosis is primarily clinical, supported by audiometric testing to confirm the degree of hearing loss. Management often involves corticosteroids to reduce inflammation and improve hearing outcomes, although the effectiveness can vary. Early intervention is crucial, as prompt treatment may enhance recovery chances. Follow-up audiological assessments are recommended to monitor any changes in hearing status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified ear designation complicates coding for specific interventions.
  • Differentiating from other types of hearing loss requires thorough documentation.
  • Potential overlap with other hearing loss codes necessitates careful review.
  • Variability in treatment protocols may affect coding accuracy.

Audit Risk Factors

  • Inadequate documentation of the onset and duration of symptoms.
  • Failure to document audiometric testing results.
  • Lack of clarity regarding the absence of identifiable causes.
  • Misclassification of hearing loss type leading to incorrect coding.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with sudden hearing loss, tinnitus, or ear fullness.

Billing Considerations

Ensure documentation specifies the absence of identifiable causes and treatment rationale.

Audiology

Documentation Requirements

Comprehensive audiological evaluations and patient history.

Common Clinical Scenarios

Assessment of patients with sudden hearing loss for differential diagnosis.

Billing Considerations

Document all findings clearly to support coding and billing.

Coding Guidelines

Inclusion Criteria

Use H91.20 When
  • According to ICD
  • 10 guidelines, H91
  • 20 is used when the hearing loss is sudden and idiopathic, with no specified ear
  • Coders must ensure that documentation supports the diagnosis and that other potential causes have been ruled out

Exclusion Criteria

Do NOT use H91.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used to assess the degree of hearing loss in patients with sudden hearing loss.

Documentation Requirements

Document the results of the audiometric evaluation and any relevant patient history.

Specialty Considerations

Otolaryngologists and audiologists should ensure thorough documentation to support the necessity of the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hearing loss conditions, improving the accuracy of diagnoses and treatment tracking. H91.20 reflects the need for precise documentation to support the diagnosis of sudden idiopathic hearing loss.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hearing loss conditions, improving the accuracy of diagnoses and treatment tracking. H91.20 reflects the need for precise documentation to support the diagnosis of sudden idiopathic hearing loss.

Reimbursement & Billing Impact

reimbursement.

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 treatment for sudden idiopathic hearing loss?

The primary treatment for sudden idiopathic hearing loss typically involves corticosteroids to reduce inflammation and improve hearing outcomes. Early intervention is crucial for the best prognosis.