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ICD-10 Guide
ICD-10 CodesH93.91

H93.91

Billable

Unspecified disorder of right ear

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

Code Description

ICD-10 H93.91 is a billable code used to indicate a diagnosis of unspecified disorder of right ear.

Key Diagnostic Point:

The ICD-10 code H93.91 refers to an unspecified disorder of the right ear, which encompasses a variety 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 disorders that may fall under this code include otitis media, hearing loss, and vestibular dysfunction. 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 other conditions. Management strategies can vary widely depending on the underlying cause but may include medical treatment, surgical interventions, or referral to specialists such as otolaryngologists. Accurate documentation is crucial to ensure appropriate coding and reimbursement, as unspecified codes can lead to increased scrutiny during audits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for thorough documentation to specify the disorder
  • Potential overlap with other ear-related codes
  • Lack of specificity may lead to coding errors

Audit Risk Factors

  • Use of unspecified codes without adequate documentation
  • Inconsistent coding practices across providers
  • Failure to document the clinical rationale for the diagnosis
  • Lack of follow-up documentation for ongoing conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including history, examination findings, and diagnostic tests performed.

Common Clinical Scenarios

Patients presenting with ear pain, hearing loss, or balance issues requiring further evaluation.

Billing Considerations

Ensure that the specific nature of the ear disorder is documented to avoid the use of unspecified codes.

Audiology

Documentation Requirements

Audiometric test results, patient history, and any referrals made.

Common Clinical Scenarios

Patients undergoing hearing assessments due to reported hearing loss or tinnitus.

Billing Considerations

Document the specific type of hearing loss and any interventions recommended.

Coding Guidelines

Inclusion Criteria

Use H93.91 When
  • According to ICD
  • 10 coding guidelines, H93
  • 91 should be used when the specific disorder of the right ear is not identified
  • Coders should ensure that all documentation supports the use of this code and that it is not used inappropriately when a more specific code is available

Exclusion Criteria

Do NOT use H93.91 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

Used when a patient presents with ear blockage due to wax buildup.

Documentation Requirements

Document the reason for the procedure and any prior treatments attempted.

Specialty Considerations

Otolaryngologists should ensure that the procedure is medically necessary.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding ear disorders. However, the use of unspecified codes like H93.91 may increase if documentation is not thorough, potentially impacting reimbursement and audit outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding ear disorders. However, the use of unspecified codes like H93.91 may increase if documentation is not thorough, potentially impacting reimbursement and audit outcomes.

Reimbursement & Billing Impact

reimbursement and audit outcomes.

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 H93.91?

H93.91 should be used when a patient presents with an ear disorder that cannot be specified further. Ensure that documentation supports the use of this code.