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ICD-10 Guide
ICD-10 CodesH91.21

H91.21

Billable

Sudden idiopathic hearing loss, right ear

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

Code Description

ICD-10 H91.21 is a billable code used to indicate a diagnosis of sudden idiopathic hearing loss, right 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 primarily affects one ear, in this case, the right ear. Patients may present with a range of symptoms including a feeling of fullness in the ear, tinnitus (ringing in the ear), and a noticeable decrease in hearing ability. The etiology of SIHL remains largely unknown, although it may be associated with viral infections, vascular disorders, or autoimmune conditions. Diagnosis is often made through audiometric testing, which confirms the degree of hearing loss, and exclusion of other potential causes such as otitis media, acoustic neuroma, or Meniere's disease. Management typically involves corticosteroid therapy to reduce inflammation and promote recovery of hearing. Early intervention is crucial, as prompt treatment may improve outcomes. Follow-up audiological assessments are recommended to monitor recovery and determine the need for further intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of hearing loss
  • Need for comprehensive documentation of symptoms and onset
  • Potential overlap with other ear conditions
  • Variability in treatment protocols

Audit Risk Factors

  • Inadequate documentation of symptom onset
  • Failure to provide audiometric test results
  • Misclassification of hearing loss type
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of hearing loss onset, audiometric test results, and treatment plan.

Common Clinical Scenarios

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

Billing Considerations

Ensure documentation reflects the idiopathic nature of the hearing loss and any exclusionary tests performed.

Audiology

Documentation Requirements

Comprehensive audiological evaluation results and patient history.

Common Clinical Scenarios

Patients undergoing hearing assessments for sudden hearing loss.

Billing Considerations

Document the degree of hearing loss and any recommendations for follow-up or rehabilitation.

Coding Guidelines

Inclusion Criteria

Use H91.21 When
  • According to ICD
  • 10 guidelines, H91
  • 21 should be used when the hearing loss is sudden and idiopathic, with no other underlying conditions identified
  • It is important to document the onset and any relevant diagnostic tests performed

Exclusion Criteria

Do NOT use H91.21 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 evaluate the degree of hearing loss in patients with sudden hearing loss.

Documentation Requirements

Audiometric test results must be documented.

Specialty Considerations

Otolaryngologists and audiologists should ensure accurate coding based on test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sudden idiopathic hearing loss, improving the ability to track and manage this condition effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sudden idiopathic hearing loss, improving the ability to track and manage this condition effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sudden idiopathic hearing loss, improving the ability to track and manage this condition effectively.

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 is corticosteroid therapy, which may help reduce inflammation and improve hearing recovery.