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ICD-10 Guide
ICD-10 CodesH92.12

H92.12

Billable

Otorrhea, left ear

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

Code Description

ICD-10 H92.12 is a billable code used to indicate a diagnosis of otorrhea, left ear.

Key Diagnostic Point:

Otorrhea, or ear discharge, is a clinical condition characterized by the presence of fluid or pus draining from the ear canal. This condition can arise from various underlying causes, including otitis media (middle ear infection), otitis externa (outer ear infection), or perforation of the tympanic membrane. Patients may present with symptoms such as ear pain, hearing loss, and a sensation of fullness in the ear. The discharge may be serous, purulent, or bloody, depending on the etiology. Diagnosis typically involves a thorough clinical examination, including otoscopy to visualize the ear canal and tympanic membrane, and may be supplemented by audiometric testing to assess hearing loss. Management of otorrhea focuses on treating the underlying cause, which may include antibiotics for bacterial infections, analgesics for pain relief, and in some cases, surgical intervention such as tympanostomy or myringotomy to facilitate drainage. Accurate coding of otorrhea is essential for proper reimbursement and tracking of ear-related diseases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of otorrhea (serous vs. purulent)
  • Identifying the underlying cause (otitis media vs. otitis externa)
  • Potential for co-existing conditions (e.g., hearing loss, perforated tympanic membrane)
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of the cause of otorrhea
  • Failure to document associated symptoms such as hearing loss
  • Misclassification of the type of otorrhea
  • Lack of clarity on treatment provided

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed notes on the patient's history, physical examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with recurrent ear infections, chronic otorrhea, or post-surgical follow-ups.

Billing Considerations

Ensure documentation reflects the severity and duration of symptoms to support the diagnosis.

Pediatrics

Documentation Requirements

Comprehensive history including vaccination status and previous ear infections.

Common Clinical Scenarios

Children with recurrent otitis media leading to otorrhea.

Billing Considerations

Consider age-related factors in diagnosis and treatment, as well as parental concerns.

Coding Guidelines

Inclusion Criteria

Use H92.12 When
  • According to ICD
  • 10 guidelines, H92
  • 12 should be used when the clinical documentation specifies otorrhea localized to the left ear
  • It is important to ensure that the documentation supports the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use H92.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Tympanostomy, general anesthesia

Clinical Scenario

Used in cases of recurrent otorrhea due to otitis media requiring drainage.

Documentation Requirements

Document the indication for surgery, pre-operative assessment, and post-operative care.

Specialty Considerations

Otolaryngologists should ensure that all surgical interventions are well-documented to support coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the granularity of data collection and reimbursement processes. H92.12 provides a clear distinction for otorrhea localized to the left ear, enhancing clinical documentation and coding accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the granularity of data collection and reimbursement processes. H92.12 provides a clear distinction for otorrhea localized to the left ear, enhancing clinical documentation and coding accuracy.

Reimbursement & Billing Impact

reimbursement processes. H92.12 provides a clear distinction for otorrhea localized to the left ear, enhancing clinical documentation and coding accuracy.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between H92.12 and H92.11?

H92.12 is used for otorrhea specifically in the left ear, while H92.11 is for the right ear. Accurate coding depends on the documentation specifying which ear is affected.