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ICD-10 Guide
ICD-10 CodesH61.001

H61.001

Billable

Unspecified perichondritis of right external ear

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

Code Description

ICD-10 H61.001 is a billable code used to indicate a diagnosis of unspecified perichondritis of right external ear.

Key Diagnostic Point:

Unspecified perichondritis of the right external ear refers to an inflammatory condition affecting the perichondrium, the connective tissue surrounding the cartilage of the ear. This condition can arise from various causes, including trauma, infection, or systemic diseases. Clinically, patients may present with localized pain, swelling, and tenderness in the external ear, often accompanied by erythema. In some cases, there may be discharge or crusting if the condition is secondary to an infection. Diagnosis typically involves a thorough clinical examination, and imaging studies may be warranted to rule out abscess formation or other complications. Management often includes the use of antibiotics if an infection is suspected, along with analgesics for pain relief. In severe cases, surgical intervention may be necessary to drain abscesses or remove necrotic tissue. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for differentiation from other ear conditions
  • Potential for concurrent infections or complications
  • Documentation requirements for specificity

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the laterality of the condition
  • Misclassification of perichondritis as otitis externa
  • Lack of supporting documentation for treatment provided

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, swelling, or discharge.

Billing Considerations

Ensure documentation reflects the cause of perichondritis and any associated conditions.

Primary Care

Documentation Requirements

Comprehensive history and physical examination, including any systemic symptoms.

Common Clinical Scenarios

Initial evaluation of ear pain or swelling before referral to specialists.

Billing Considerations

Document any prior treatments or interventions to provide context for the condition.

Coding Guidelines

Inclusion Criteria

Use H61.001 When
  • Follow official coding guidelines for specificity and laterality
  • Ensure that the diagnosis is supported by clinical documentation and that any related procedures are appropriately linked

Exclusion Criteria

Do NOT use H61.001 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69200CPT Code

Removal of impacted cerumen

Clinical Scenario

Often performed in conjunction with the evaluation of ear pain.

Documentation Requirements

Document the reason for cerumen removal and any findings during the procedure.

Specialty Considerations

Otolaryngologists may perform this procedure more frequently than primary care providers.

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, including perichondritis, which enhances the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, including perichondritis, which enhances the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Coding & Billing References

  • •
    American Academy of Otolaryngology - Head and Neck Surgery

Frequently Asked Questions

What are the common causes of perichondritis?

Common causes include trauma, infections (bacterial or fungal), and systemic conditions such as autoimmune diseases.