ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesJ11.83

J11.83

Influenza due to unidentified influenza virus with otitis media

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J11.83 is a billable code used to indicate a diagnosis of influenza due to unidentified influenza virus with otitis media.

Key Diagnostic Point:

J11.83 refers to influenza caused by an unidentified influenza virus, accompanied by otitis media. Clinically, patients may present with typical influenza symptoms such as fever, chills, cough, sore throat, body aches, and fatigue. The involvement of otitis media, an infection of the middle ear, can lead to additional symptoms including ear pain, irritability in children, and potential hearing loss. The respiratory system is primarily affected by the influenza virus, which targets the epithelial cells of the upper and lower respiratory tracts, leading to inflammation and increased mucus production. Disease progression can vary; while many patients recover within a week, complications such as secondary bacterial infections, including otitis media, can arise, particularly in pediatric and immunocompromised populations. Diagnostic considerations include clinical evaluation and, if necessary, laboratory testing such as rapid influenza diagnostic tests (RIDTs) or PCR assays to confirm the presence of the influenza virus. The identification of otitis media may require otoscopic examination and further evaluation if symptoms persist or worsen.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other respiratory infections and consideration of secondary complications.
  • Treatment complexity: May involve antiviral medications for influenza and antibiotics for otitis media if bacterial infection is suspected.
  • Documentation requirements: Detailed clinical notes on symptoms, diagnostic tests, and treatment plans are essential.
  • Coding specificity: Requires accurate coding to reflect both the influenza diagnosis and the associated otitis media.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of influenza or failure to document the presence of otitis media.
  • Documentation gaps: Incomplete clinical notes regarding the patient's symptoms and treatment plan.
  • Billing challenges: Potential denials if the relationship between influenza and otitis media is not clearly established.

Specialty Focus

Medical Specialties

Primary medical specialty: Family Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of J11.83 lies in its potential to lead to complications such as otitis media, particularly in vulnerable populations like children and the elderly. Understanding this code aids in tracking influenza-related morbidity and informs public health strategies aimed at reducing the incidence of respiratory infections. Quality measures may include monitoring vaccination rates and the effectiveness of treatment protocols, while healthcare utilization patterns can reveal trends in emergency department visits and hospitalizations related to influenza and its complications.

ICD-9 vs ICD-10

The clinical significance of J11.83 lies in its potential to lead to complications such as otitis media, particularly in vulnerable populations like children and the elderly. Understanding this code aids in tracking influenza-related morbidity and informs public health strategies aimed at reducing the incidence of respiratory infections. Quality measures may include monitoring vaccination rates and the effectiveness of treatment protocols, while healthcare utilization patterns can reveal trends in emergency department visits and hospitalizations related to influenza and its complications.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the services rendered align with the diagnosis and that any associated treatments are justified. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for both the influenza and otitis media diagnoses. Best practices include thorough documentation of patient encounters, clear linkage between symptoms and diagnoses, and adherence to payer-specific guidelines.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J11.83?

J11.83 covers cases of influenza caused by an unidentified influenza virus that is associated with otitis media. This includes patients presenting with flu-like symptoms and concurrent ear infections.

When should J11.83 be used instead of related codes?

J11.83 should be used when a patient has confirmed influenza symptoms along with otitis media, particularly when the influenza virus type is not identified. It is distinct from codes that specify other complications or types of influenza.

What documentation supports J11.83?

Documentation should include clinical findings of influenza symptoms, results from any diagnostic tests confirming influenza, and evidence of otitis media, such as otoscopic findings or patient-reported symptoms.