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ICD-10 Guide
ICD-10 CodesH62.42

H62.42

Billable

Otitis externa in other diseases classified elsewhere, left ear

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

Code Description

ICD-10 H62.42 is a billable code used to indicate a diagnosis of otitis externa in other diseases classified elsewhere, left ear.

Key Diagnostic Point:

Otitis externa, commonly known 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 or psoriasis, which may predispose the ear canal to infection. Clinically, patients may present with symptoms such as ear pain, itching, discharge, and sometimes hearing loss. The left ear designation is crucial for accurate coding, especially in cases where bilateral involvement is not present. Diagnosis typically involves a thorough history and physical examination, often supplemented by otoscopic evaluation to visualize the ear canal and tympanic membrane. Management may include topical antibiotics, corticosteroids, and analgesics, depending on the severity and underlying cause. In cases where otitis externa is secondary to other diseases, it is essential to document the primary condition to justify the use of this specific code. Accurate coding is vital for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying conditions causing otitis externa.
  • Need for precise documentation of the left ear involvement.
  • Differentiation from other types of otitis (e.g., otitis media).
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the affected ear.
  • Misclassification of the type of otitis.
  • Lack of supporting clinical evidence for the diagnosis.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of ear symptoms, examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with ear pain and discharge, particularly in the context of skin conditions.

Billing Considerations

Ensure documentation reflects the relationship between the underlying condition and otitis externa.

Dermatology

Documentation Requirements

History of skin conditions affecting the ear, treatment details, and any referrals made.

Common Clinical Scenarios

Patients with eczema or psoriasis experiencing ear canal infections.

Billing Considerations

Document the skin condition's role in the development of otitis externa.

Coding Guidelines

Inclusion Criteria

Use H62.42 When
  • According to ICD
  • 10 guidelines, H62
  • 42 should be used when otitis externa is a complication of another disease
  • Coders must ensure that the primary condition is documented and that the otitis externa is specifically noted as affecting the left ear

Exclusion Criteria

Do NOT use H62.42 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, 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 otitis externa, 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 significance of specifying the left ear in H62.42?

Specifying the left ear is crucial for accurate coding, especially in cases where bilateral involvement is not present. It ensures proper treatment and reimbursement.