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ICD-10 Guide
ICD-10 CodesH61.011

H61.011

Billable

Acute perichondritis of right external ear

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

Code Description

ICD-10 H61.011 is a billable code used to indicate a diagnosis of acute perichondritis of right external ear.

Key Diagnostic Point:

Acute perichondritis of the right external ear is an inflammatory condition affecting the perichondrium, the connective tissue surrounding the cartilage of the ear. This condition is often characterized by localized pain, swelling, and redness of the external ear, particularly the auricle. Acute perichondritis can arise from various causes, including trauma, infection, or surgical interventions. The condition may present with symptoms such as tenderness upon palpation, warmth, and sometimes fever if an infectious etiology 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 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 any abscesses or to remove necrotic tissue. Prompt treatment is crucial to prevent complications such as permanent deformity of the ear or spread of infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Identifying the specific ear involved (right vs. left)
  • Understanding the underlying causes (infectious vs. non-infectious)
  • Documenting associated symptoms and treatments accurately

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the affected ear
  • Misclassification of acute vs. chronic conditions
  • Lack of supporting evidence for surgical interventions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with ear pain, swelling, and fever following trauma or surgery.

Billing Considerations

Ensure clear documentation of the cause of perichondritis and any surgical interventions performed.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings.

Common Clinical Scenarios

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

Billing Considerations

Document any prior treatments and the patient's response to them.

Coding Guidelines

Inclusion Criteria

Use H61.011 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's acute nature and the specific ear involved
  • Include any relevant history of trauma or infection

Exclusion Criteria

Do NOT use H61.011 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69200CPT Code

Removal of impacted cerumen

Clinical Scenario

Used when cerumen impaction is present alongside perichondritis.

Documentation Requirements

Document the presence of cerumen and the procedure performed.

Specialty Considerations

Otolaryngologists may perform this procedure in conjunction with treatment for perichondritis.

10060CPT Code

Incision and drainage of abscess

Clinical Scenario

Used if an abscess develops due to perichondritis.

Documentation Requirements

Document the size, location, and nature of the abscess.

Specialty Considerations

Ensure clear documentation of the need for surgical intervention.

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 tracking. H61.011 provides specificity that was not available in ICD-9.

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 tracking. H61.011 provides specificity that was not available in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ear conditions, improving the accuracy of diagnoses and treatment tracking. H61.011 provides specificity that was not available in ICD-9.

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 acute perichondritis?

Common causes include trauma, surgical procedures, and infections, particularly bacterial infections following ear piercings or injuries.

How is acute perichondritis diagnosed?

Diagnosis is primarily clinical, based on the presentation of symptoms such as pain, swelling, and redness of the ear. Imaging may be used to rule out complications.

What is the typical treatment for acute perichondritis?

Treatment usually involves antibiotics for infection, pain management, and in some cases, surgical drainage if an abscess forms.