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ICD-10 Guide
ICD-10 CodesH61.111

H61.111

Billable

Acquired deformity of pinna, right ear

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

Code Description

ICD-10 H61.111 is a billable code used to indicate a diagnosis of acquired deformity of pinna, right ear.

Key Diagnostic Point:

Acquired deformity of the pinna refers to structural changes or malformations of the outer ear that occur due to various factors such as trauma, infection, or surgical intervention. The pinna, or auricle, is the visible part of the ear that collects sound waves and directs them into the ear canal. Conditions leading to acquired deformities may include lacerations, burns, or surgical alterations following procedures such as otoplasty or excision of tumors. Clinical presentation may vary from mild deformities, which may not affect hearing, to severe malformations that can lead to cosmetic concerns and potential hearing loss. Diagnosis typically involves a thorough physical examination, patient history, and imaging studies if necessary. Management may include surgical correction, prosthetic devices, or cosmetic interventions, depending on the severity and underlying cause of the deformity. Accurate coding is essential for proper reimbursement and to reflect the patient's condition in medical records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of deformities
  • Need for detailed documentation of the cause and extent of the deformity
  • Potential for multiple underlying conditions affecting the ear
  • Differentiation from congenital deformities

Audit Risk Factors

  • Inadequate documentation of the deformity's cause
  • Failure to specify the right ear in documentation
  • Lack of clarity on the impact of the deformity on hearing
  • Inconsistent coding for related procedures

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed descriptions of the deformity, including measurements and photographs if applicable.

Common Clinical Scenarios

Patients presenting with trauma to the ear, post-surgical deformities, or congenital deformities requiring correction.

Billing Considerations

Ensure that the documentation clearly states the acquired nature of the deformity and any associated hearing loss.

Plastic Surgery

Documentation Requirements

Comprehensive surgical notes detailing the procedure performed and the rationale for intervention.

Common Clinical Scenarios

Reconstructive surgery following trauma or cosmetic procedures to correct ear deformities.

Billing Considerations

Document the patient's history of the deformity and any previous surgeries to avoid confusion in coding.

Coding Guidelines

Inclusion Criteria

Use H61.111 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only for acquired deformities of the pinna

Exclusion Criteria

Do NOT use H61.111 When
  • Exclude congenital deformities and ensure that the right ear is specified in the documentation

Related ICD-10 Codes

Related CPT Codes

69300CPT Code

Otoplasty

Clinical Scenario

Used for surgical correction of ear deformities.

Documentation Requirements

Surgical notes detailing the procedure and rationale for correction.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of acquired deformity.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like acquired deformities of the pinna, improving 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 conditions like acquired deformities of the pinna, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 the difference between acquired and congenital deformities of the pinna?

Acquired deformities occur due to external factors such as trauma or surgery, while congenital deformities are present at birth and result from genetic or developmental issues.