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ICD-10 Guide
ICD-10 CodesH61.119

H61.119

Billable

Acquired deformity of pinna, unspecified ear

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

Code Description

ICD-10 H61.119 is a billable code used to indicate a diagnosis of acquired deformity of pinna, unspecified ear.

Key Diagnostic Point:

Acquired deformity of the pinna refers to any structural abnormality of the outer ear that develops after birth due to various factors such as trauma, infection, or surgical intervention. This condition can manifest as changes in shape, size, or position of the pinna, which may affect the patient's hearing ability and aesthetic appearance. Common causes include trauma from accidents, burns, or surgical procedures such as otoplasty. Patients may present with complaints of hearing loss, discomfort, or cosmetic concerns. Diagnosis typically involves a thorough physical examination and may include imaging studies to assess underlying structures. Management may involve surgical correction, prosthetic devices, or referral to audiology for hearing assessments. The condition is classified as 'unspecified' when the exact cause or nature of the deformity is not clearly defined, necessitating careful documentation to support the diagnosis and any associated treatments.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and causes of deformity
  • Need for detailed documentation to support the diagnosis
  • Potential overlap with congenital deformities
  • Variations in treatment approaches based on etiology

Audit Risk Factors

  • Inadequate documentation of the deformity's cause
  • Failure to specify the affected ear when applicable
  • Lack of supporting evidence for associated hearing loss
  • Misclassification with congenital deformities

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes describing the deformity, its cause, and any associated symptoms.

Common Clinical Scenarios

Patients presenting with post-traumatic ear deformities or those seeking cosmetic correction.

Billing Considerations

Ensure clear documentation of the deformity's impact on hearing and any surgical interventions performed.

Audiology

Documentation Requirements

Audiometric evaluations and reports detailing the impact of the deformity on hearing.

Common Clinical Scenarios

Patients with acquired deformities presenting for hearing assessments.

Billing Considerations

Document any recommendations for hearing aids or other assistive devices.

Coding Guidelines

Inclusion Criteria

Use H61.119 When
  • According to ICD
  • 10 guidelines, this code should be used when the deformity is acquired and not congenital
  • Documentation must clearly indicate the nature of the deformity and any associated conditions

Exclusion Criteria

Do NOT use H61.119 When
  • Exclusion criteria include congenital deformities and conditions that do not affect the pinna

Related ICD-10 Codes

Related CPT Codes

69300CPT Code

Otoplasty

Clinical Scenario

Used for surgical correction of ear deformities.

Documentation Requirements

Pre-operative assessment, surgical notes, and post-operative follow-up.

Specialty Considerations

Otolaryngologists should document the rationale for surgery and expected outcomes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the accuracy of claims and facilitating better patient management. This code provides a clear distinction from congenital deformities, which is crucial for appropriate treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired deformities, improving the accuracy of claims and facilitating better patient management. This code provides a clear distinction from congenital deformities, which is crucial for appropriate treatment planning.

Reimbursement & Billing Impact

reimbursement.

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 develop after birth due to factors such as trauma or infection, while congenital deformities are present at birth and result from genetic or developmental issues.