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ICD-10 Guide
ICD-10 CodesH93.90

H93.90

Billable

Unspecified disorder of ear, unspecified ear

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

Code Description

ICD-10 H93.90 is a billable code used to indicate a diagnosis of unspecified disorder of ear, unspecified ear.

Key Diagnostic Point:

H93.90 refers to an unspecified disorder of the ear, which encompasses a wide range of conditions affecting the ear's structure and function. This code is often used when the specific nature of the ear disorder is not clearly defined or documented. Common conditions that may fall under this code include otitis media, hearing loss, and vestibular disorders. Patients may present with symptoms such as ear pain, hearing impairment, tinnitus, or balance issues. Diagnostic criteria typically involve a thorough clinical examination, audiometric testing, and possibly imaging studies to rule out specific pathologies. Management strategies can vary widely, from conservative measures such as observation and medication to surgical interventions like tympanostomy or mastoidectomy, depending on the underlying cause. Accurate documentation is crucial to ensure appropriate coding and reimbursement, as well as to facilitate effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Vague nature of the diagnosis requiring further specification.
  • Potential overlap with other ear-related codes.
  • Need for comprehensive documentation to justify the use of this code.
  • Variability in clinical presentation and management strategies.

Audit Risk Factors

  • Insufficient documentation to support the unspecified diagnosis.
  • Inconsistent use of the code across different encounters.
  • Failure to provide adequate clinical rationale for the unspecified nature.
  • Potential for upcoding if more specific conditions are present but not documented.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including history, examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with ear pain, hearing loss, or balance issues without a clear diagnosis.

Billing Considerations

Ensure that all relevant tests and evaluations are documented to support the use of H93.90.

Audiology

Documentation Requirements

Audiometric test results and interpretation, along with patient history.

Common Clinical Scenarios

Patients undergoing hearing assessments where the cause of hearing loss is not immediately identifiable.

Billing Considerations

Document any referrals or follow-up plans to clarify the diagnosis.

Coding Guidelines

Inclusion Criteria

Use H93.90 When
  • According to ICD
  • 10 coding guidelines, H93
  • 90 should be used when the specific disorder of the ear is not documented
  • Coders should ensure that all relevant clinical information is captured to justify the use of this unspecified code
  • It is important to review the patient's medical history and any diagnostic tests performed

Exclusion Criteria

Do NOT use H93.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

Used when cerumen impaction is suspected as a cause of ear symptoms.

Documentation Requirements

Document the presence of cerumen and the procedure performed.

Specialty Considerations

Otolaryngologists may frequently perform this procedure.

92557CPT Code

Comprehensive audiometry threshold evaluation

Clinical Scenario

Used when assessing hearing loss in patients with unspecified ear disorders.

Documentation Requirements

Include detailed audiometric results and patient history.

Specialty Considerations

Audiologists should ensure thorough documentation to support the evaluation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of ear disorders, but it has also increased the complexity of coding due to the introduction of unspecified codes like H93.90. Coders must be diligent in ensuring that documentation supports the use of this code.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of ear disorders, but it has also increased the complexity of coding due to the introduction of unspecified codes like H93.90. Coders must be diligent in ensuring that documentation supports the use of this code.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of ear disorders, but it has also increased the complexity of coding due to the introduction of unspecified codes like H93.90. Coders must be diligent in ensuring that documentation supports the use of this code.

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

When should I use H93.90?

H93.90 should be used when there is an unspecified disorder of the ear and no specific diagnosis can be determined based on the clinical evaluation and documentation.

What documentation is needed to support the use of H93.90?

Documentation should include a detailed history, physical examination findings, and any diagnostic tests performed that indicate an ear disorder without a specific diagnosis.