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ICD-10 Guide
ICD-10 CodesH66.11

H66.11

Billable

Chronic tubotympanic suppurative otitis media, right ear

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

Code Description

ICD-10 H66.11 is a billable code used to indicate a diagnosis of chronic tubotympanic suppurative otitis media, right ear.

Key Diagnostic Point:

Chronic tubotympanic suppurative otitis media is a persistent inflammatory condition of the middle ear characterized by the presence of pus and a perforated tympanic membrane. This condition typically arises from recurrent acute otitis media or Eustachian tube dysfunction, leading to chronic infection and inflammation. Patients may present with symptoms such as ear pain, hearing loss, and discharge from the ear. The right ear designation indicates the affected side, which is crucial for accurate diagnosis and treatment planning. Diagnosis is often confirmed through otoscopic examination, which reveals a perforated tympanic membrane and purulent discharge. Management may include antibiotic therapy, surgical intervention such as tympanoplasty, or ventilation tube placement to facilitate drainage and restore hearing. Chronic cases may lead to complications such as cholesteatoma or hearing loss, necessitating ongoing monitoring and potential surgical intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic forms of otitis media
  • Identifying the specific ear affected (right vs. left)
  • Understanding the implications of suppurative versus non-suppurative conditions
  • Navigating the potential for co-existing conditions (e.g., hearing loss)

Audit Risk Factors

  • Inadequate documentation of chronicity
  • Failure to specify the affected ear
  • Misclassification of the type of otitis media
  • Lack of supporting clinical evidence for surgical interventions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with recurrent ear infections, chronic ear discharge, or hearing loss.

Billing Considerations

Ensure clear documentation of the type of otitis media and any surgical interventions performed.

Pediatrics

Documentation Requirements

Growth and development assessments, family history of ear conditions, and vaccination status.

Common Clinical Scenarios

Children with recurrent ear infections or those requiring tympanostomy tubes.

Billing Considerations

Consider age-related factors in diagnosis and treatment, as well as parental education on ear health.

Coding Guidelines

Inclusion Criteria

Use H66.11 When
  • According to ICD
  • 10 guidelines, H66
  • 11 should be used when there is clear documentation of chronic suppurative otitis media affecting the right ear
  • It is important to document the duration of symptoms and any prior treatments

Exclusion Criteria

Do NOT use H66.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanoplasty

Clinical Scenario

Used for surgical repair of the tympanic membrane in patients with chronic suppurative otitis media.

Documentation Requirements

Operative report detailing the procedure, indication for surgery, and post-operative care plan.

Specialty Considerations

Otolaryngologists should ensure that the surgical necessity is well-documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chronic conditions like H66.11, improving the accuracy of patient records and facilitating better management of chronic ear diseases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chronic conditions like H66.11, improving the accuracy of patient records and facilitating better management of chronic ear diseases.

Reimbursement & Billing Impact

reimbursement.

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 symptoms of chronic tubotympanic suppurative otitis media?

Common symptoms include ear pain, persistent ear discharge, hearing loss, and a feeling of fullness in the ear.

How is chronic tubotympanic suppurative otitis media diagnosed?

Diagnosis is typically made through otoscopic examination, which reveals a perforated tympanic membrane and purulent discharge, along with patient history and audiometric testing.