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ICD-10 Guide
ICD-10 CodesH61.003

H61.003

Billable

Unspecified perichondritis of external ear, bilateral

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

Code Description

ICD-10 H61.003 is a billable code used to indicate a diagnosis of unspecified perichondritis of external ear, bilateral.

Key Diagnostic Point:

Unspecified perichondritis of the external ear, bilateral, refers to an inflammatory condition affecting the perichondrium, the connective tissue surrounding the cartilage of the ear. This condition can arise from various etiologies, including trauma, infection, or systemic diseases. Clinically, patients may present with pain, swelling, and tenderness of the external ear, often accompanied by erythema. In severe cases, there may be associated fever or systemic symptoms. Diagnosis is typically made through clinical examination, although imaging studies may be warranted to rule out abscess formation or other complications. Management often involves the use of antibiotics if an infectious cause is suspected, along with anti-inflammatory medications to alleviate pain and swelling. In chronic or 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 thorough documentation to support diagnosis
  • Potential for misdiagnosis with other ear conditions
  • Variability in treatment approaches based on severity

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify bilateral involvement
  • Lack of supporting evidence for treatment decisions
  • Misalignment between diagnosis and procedure codes

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 infection requiring surgical intervention.

Billing Considerations

Ensure clear documentation of bilateral involvement and any prior treatments.

Primary Care

Documentation Requirements

Comprehensive patient history and symptom description, including any relevant systemic conditions.

Common Clinical Scenarios

Initial evaluation of ear pain or swelling before referral to a specialist.

Billing Considerations

Document any systemic symptoms that may indicate a more serious underlying condition.

Coding Guidelines

Inclusion Criteria

Use H61.003 When
  • Follow official coding guidelines for the use of H61
  • 003, ensuring that the diagnosis is supported by clinical documentation
  • This code should be used when the specific cause of perichondritis is not identified

Exclusion Criteria

Do NOT use H61.003 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 evaluation of ear conditions.

Documentation Requirements

Document the reason for cerumen removal and any associated ear conditions.

Specialty Considerations

Otolaryngologists may perform this procedure frequently in patients with ear inflammation.

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 bilateral 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 bilateral 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 diseases such as autoimmune disorders.