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ICD-10 Guide
ICD-10 CodesH66.21

H66.21

Billable

Chronic atticoantral suppurative otitis media, right ear

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

Code Description

ICD-10 H66.21 is a billable code used to indicate a diagnosis of chronic atticoantral suppurative otitis media, right ear.

Key Diagnostic Point:

Chronic atticoantral suppurative otitis media is a persistent infection of the middle ear characterized by the presence of pus and inflammation, specifically affecting the atticoantral region of the ear. This condition often arises from recurrent acute otitis media or can develop as a result of eustachian tube dysfunction, leading to the accumulation of fluid and bacteria in the middle ear space. Patients typically 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. Chronic suppurative otitis media can lead to complications such as mastoiditis, cholesteatoma, and hearing impairment if left untreated. Diagnosis is confirmed through clinical evaluation, otoscopic examination, and audiometric testing. Management often involves antibiotic therapy, surgical intervention such as tympanoplasty or mastoidectomy, and regular follow-up to monitor for recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic forms of otitis media
  • Identifying the specific anatomical region affected (atticoantral)
  • Documenting the presence of complications such as cholesteatoma
  • Understanding the nuances of bilateral versus unilateral coding

Audit Risk Factors

  • Inadequate documentation of chronicity
  • Failure to specify the affected ear
  • Lack of evidence for surgical interventions if performed
  • Misclassification of acute versus chronic otitis media

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of ear infections, audiometric results, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Ensure documentation reflects the chronic nature and any surgical interventions performed.

Pediatrics

Documentation Requirements

Growth and development assessments, family history of ear infections.

Common Clinical Scenarios

Children with frequent ear infections or persistent otorrhea.

Billing Considerations

Consider age-related factors in treatment and documentation.

Coding Guidelines

Inclusion Criteria

Use H66.21 When
  • Follow the official ICD
  • CM coding guidelines, ensuring to document the chronicity of the condition and specify the affected ear

Exclusion Criteria

Do NOT use H66.21 When
  • Exclude codes for acute otitis media unless applicable

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanoplasty

Clinical Scenario

Performed for chronic otitis media with tympanic membrane perforation.

Documentation Requirements

Operative report detailing the procedure and indication.

Specialty Considerations

Otolaryngologists should ensure all pre-operative evaluations are 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 H66.21, 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 H66.21, improving the accuracy of patient records and facilitating better management of chronic ear diseases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of chronic conditions like H66.21, improving the accuracy of patient records and facilitating better management of chronic ear diseases.

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 is the difference between acute and chronic otitis media?

Acute otitis media is a sudden onset infection characterized by rapid symptoms, while chronic otitis media persists for an extended period, often with recurrent infections and ongoing symptoms.