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ICD-10 Guide
ICD-10 CodesH62.40

H62.40

Billable

Otitis externa in other diseases classified elsewhere, unspecified ear

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

Code Description

ICD-10 H62.40 is a billable code used to indicate a diagnosis of otitis externa in other diseases classified elsewhere, unspecified ear.

Key Diagnostic Point:

Otitis externa, commonly referred to as swimmer's ear, is an inflammation of the external auditory canal. This condition can arise as a complication of other diseases, such as eczema, psoriasis, or allergic reactions, leading to a secondary infection. Patients typically present with symptoms including ear pain, itching, discharge, and sometimes hearing loss. The diagnosis is primarily clinical, based on the patient's history and physical examination, which may reveal redness, swelling, and discharge in the ear canal. Management often involves cleaning the ear canal, topical antibiotics, and corticosteroids to reduce inflammation. In cases where otitis externa is secondary to other underlying conditions, it is crucial to address the primary disease to prevent recurrence. The unspecified ear designation indicates that the condition is not limited to one ear, which may complicate treatment and follow-up. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases that may cause otitis externa.
  • Differentiation from other types of otitis (e.g., otitis media).
  • Need for precise documentation of the primary condition leading to otitis externa.
  • Potential for multiple codes if coexisting conditions are present.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the ear involved when applicable.
  • Misclassification of the type of otitis (external vs. media).
  • Lack of clarity in treatment plans related to the primary condition.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes on the examination findings, treatment plans, and any underlying conditions.

Common Clinical Scenarios

Patients presenting with ear pain and discharge, often following swimming or exposure to moisture.

Billing Considerations

Ensure that the primary disease is clearly documented to support the use of H62.40.

Dermatology

Documentation Requirements

Documentation of skin conditions that may contribute to otitis externa, including treatment history.

Common Clinical Scenarios

Patients with eczema or psoriasis experiencing ear canal inflammation.

Billing Considerations

Linking skin conditions to ear symptoms is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use H62.40 When
  • According to ICD
  • 10 guidelines, H62
  • 40 should be used when otitis externa is a complication of another disease
  • Coders must ensure that the primary condition is documented and that the ear involved is specified when applicable
  • This code is not to be used for primary otitis externa without an underlying condition

Exclusion Criteria

Do NOT use H62.40 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

Often performed in conjunction with treatment for otitis externa.

Documentation Requirements

Document the reason for cerumen removal and any associated symptoms.

Specialty Considerations

Otolaryngologists may frequently perform this procedure in patients with otitis externa.

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 otitis externa, enabling better tracking of complications and associated diseases. H62.40 reflects the complexity of managing ear conditions in the context of other health issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like otitis externa, enabling better tracking of complications and associated diseases. H62.40 reflects the complexity of managing ear conditions in the context of other health issues.

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

When should I use H62.40?

Use H62.40 when otitis externa is a complication of another disease, and ensure that the primary condition is well-documented in the medical record.