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ICD-10 Guide
ICD-10 CodesH61.009

H61.009

Billable

Unspecified perichondritis of external ear, unspecified ear

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

Code Description

ICD-10 H61.009 is a billable code used to indicate a diagnosis of unspecified perichondritis of external ear, unspecified ear.

Key Diagnostic Point:

Unspecified perichondritis of the 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 redness of the external ear. In some cases, there may be associated fever or drainage if an infection is present. Diagnosis typically involves a thorough clinical examination, and imaging studies may be warranted to rule out abscess formation or other complications. Management often includes antibiotics if an infection is suspected, along with analgesics for pain control. 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 differential diagnosis to rule out other ear conditions
  • Potential for co-existing conditions that may complicate coding
  • Documentation requirements for specifying the cause of perichondritis

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the affected ear
  • Misclassification of perichondritis as otitis externa
  • Lack of supporting evidence for the diagnosis

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, swelling, or drainage.

Billing Considerations

Ensure to document the duration of symptoms and any prior treatments.

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 a specialist.

Billing Considerations

Document any relevant comorbidities that may affect treatment.

Coding Guidelines

Inclusion Criteria

Use H61.009 When
  • According to ICD
  • 10 guidelines, H61
  • 009 should be used when the specific cause of perichondritis is not documented
  • Coders should ensure that the diagnosis is supported by clinical documentation and that the condition is not better described by a more specific code

Exclusion Criteria

Do NOT use H61.009 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 symptoms.

Specialty Considerations

Otolaryngologists may perform this procedure more frequently.

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, improving the accuracy of diagnoses and treatment plans. H61.009 reflects the need for specificity in coding, which can impact reimbursement and care quality.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the accuracy of diagnoses and treatment plans. H61.009 reflects the need for specificity in coding, which can impact reimbursement and care quality.

Reimbursement & Billing Impact

reimbursement and care quality.

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 is perichondritis?

Perichondritis is an inflammation of the perichondrium, the connective tissue surrounding cartilage, often affecting the ear and can result from trauma or infection.

How is perichondritis diagnosed?

Diagnosis is primarily clinical, based on symptoms such as pain and swelling, and may involve imaging to rule out complications.

What are the treatment options for perichondritis?

Treatment typically includes antibiotics for infection, pain management, and in severe cases, surgical intervention to drain abscesses.