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ICD-10 Guide
ICD-10 CodesH91.90

H91.90

Billable

Unspecified hearing loss, unspecified ear

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

Code Description

ICD-10 H91.90 is a billable code used to indicate a diagnosis of unspecified hearing loss, unspecified ear.

Key Diagnostic Point:

Unspecified hearing loss refers to a reduction in the ability to hear sounds in one or both ears without a specific diagnosis indicating the cause or type of hearing impairment. This condition can arise from various etiologies, including age-related changes, noise exposure, ototoxic medications, or underlying medical conditions affecting the auditory system. Patients may present with symptoms such as difficulty understanding speech, asking for repetition, or turning up the volume on electronic devices. Diagnostic evaluation typically includes audiometric testing to assess the degree and type of hearing loss, alongside a thorough history and physical examination to rule out conditions like otitis media, cerumen impaction, or vestibular disorders. Management may involve hearing aids, assistive listening devices, or referral for further evaluation if a specific cause is identified. Accurate coding is essential for appropriate reimbursement and tracking of hearing loss prevalence, making it crucial for coders to understand the nuances of this code.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in the diagnosis
  • Variability in clinical presentation
  • Potential overlap with other hearing loss codes
  • Need for comprehensive documentation to support the diagnosis

Audit Risk Factors

  • Insufficient documentation of hearing loss type
  • Inconsistent use of unspecified codes
  • Failure to document patient history adequately
  • Lack of follow-up or treatment plans

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric test results, patient history, and physical examination findings.

Common Clinical Scenarios

Patients presenting with gradual hearing loss, sudden hearing changes, or complaints of tinnitus.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the unspecified diagnosis.

Audiology

Documentation Requirements

Comprehensive audiological evaluations and patient-reported outcomes.

Common Clinical Scenarios

Routine hearing assessments for patients with risk factors for hearing loss.

Billing Considerations

Document any referrals for further evaluation or treatment options.

Coding Guidelines

Inclusion Criteria

Use H91.90 When
  • According to ICD
  • 10 guidelines, H91
  • 90 should be used when the type of hearing loss is not specified
  • Coders should ensure that the documentation supports the use of this code and that no more specific codes apply

Exclusion Criteria

Do NOT use H91.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used when a patient presents with hearing loss for evaluation.

Documentation Requirements

Audiometric test results and patient history.

Specialty Considerations

Otolaryngologists and audiologists should ensure that the evaluation aligns with the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of hearing loss, but it has also introduced the potential for increased scrutiny of unspecified codes like H91.90. Coders must ensure that they are using this code appropriately and that documentation supports its use.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of hearing loss, but it has also introduced the potential for increased scrutiny of unspecified codes like H91.90. Coders must ensure that they are using this code appropriately and that documentation supports its use.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of hearing loss, but it has also introduced the potential for increased scrutiny of unspecified codes like H91.90. Coders must ensure that they are using this code appropriately and that documentation supports its use.

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

When should I use H91.90?

Use H91.90 when a patient presents with hearing loss that cannot be specifically classified into other categories. Ensure that documentation supports the unspecified nature of the hearing loss.