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ICD-10 Guide
ICD-10 CodesR94.12

R94.12

Abnormal results of function studies of ear and other special senses

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R94.12 is a billable code used to indicate a diagnosis of abnormal results of function studies of ear and other special senses.

Key Diagnostic Point:

R94.12 is used to classify abnormal results from function studies of the ear and other special senses, which may include audiometric tests, vestibular function tests, and other sensory evaluations. These tests are crucial for diagnosing conditions affecting hearing, balance, and other sensory modalities. Abnormal results may indicate a range of issues, from conductive hearing loss to vestibular disorders, and can be caused by various factors such as infections, trauma, or neurological conditions. Clinicians often rely on these studies to guide further diagnostic workup and management strategies. Accurate coding requires a thorough understanding of the underlying conditions and the specific tests performed, as well as the clinical context in which these tests were ordered.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of tests that can yield abnormal results
  • Need for precise documentation of test types and results
  • Differentiation between normal variations and pathological findings
  • Potential overlap with other codes for similar symptoms

Audit Risk Factors

  • Inadequate documentation of test results
  • Failure to specify the type of function study performed
  • Misinterpretation of normal vs. abnormal findings
  • Inconsistent coding across different encounters

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of patient history, symptoms, and specific tests performed is essential.

Common Clinical Scenarios

Patients presenting with hearing loss, tinnitus, or balance issues requiring audiometric testing.

Billing Considerations

Consider comorbid conditions that may affect sensory function, such as diabetes or hypertension.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate test results and clinical findings.

Common Clinical Scenarios

Patients with sudden hearing loss or vertigo presenting to the emergency department.

Billing Considerations

Rapid assessment and documentation of acute symptoms are critical for appropriate coding.

Coding Guidelines

Inclusion Criteria

Use R94.12 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code is used only when the abnormal results are documented and relevant to the patient's clinical picture

Exclusion Criteria

Do NOT use R94.12 When
No specific exclusions found.

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used when a patient undergoes a full audiometric evaluation due to reported hearing loss.

Documentation Requirements

Document the specific tests performed and the results.

Specialty Considerations

Audiologists should ensure that results are clearly linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data for research and clinical management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data for research and clinical management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data for research and clinical management.

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 types of tests are included under R94.12?

R94.12 encompasses various function studies, including audiometric tests, vestibular function tests, and other sensory evaluations that yield abnormal results.