Suppurative otitis media, unspecified, left ear
ICD-10 H66.42 is a billable code used to indicate a diagnosis of suppurative otitis media, unspecified, left ear.
Suppurative otitis media is an inflammatory condition of the middle ear characterized by the presence of pus. It typically arises from a bacterial infection following an upper respiratory tract infection, leading to fluid accumulation and pressure in the middle ear. Patients may present with ear pain, fever, irritability in children, and hearing loss. In cases where the condition is unspecified, it indicates that the specific causative organism or the severity of the infection has not been determined. Diagnosis is often made through clinical examination, which may include otoscopy revealing a bulging, red tympanic membrane. Management typically involves analgesics for pain relief, antibiotics for bacterial infections, and in some cases, surgical intervention such as tympanostomy tubes to drain fluid and relieve pressure. The condition can lead to complications such as hearing loss or mastoiditis if not treated appropriately.
Detailed clinical notes including patient history, examination findings, and treatment plans.
Patients presenting with ear pain, fever, and drainage from the ear.
Ensure accurate documentation of the ear affected and any surgical interventions performed.
Thorough documentation of developmental history and any recurrent episodes of otitis media.
Young children with recurrent ear infections requiring monitoring and potential referral to specialists.
Consideration of age-related factors in treatment and coding, especially in cases of recurrent infections.
Used when a patient with recurrent otitis media requires tube placement.
Document the indication for surgery and any prior treatments attempted.
Otolaryngologists should ensure that the diagnosis supports the need for surgical intervention.
H66.42 is used for acute suppurative otitis media, while H66.41 is for chronic cases. Accurate documentation of the duration and nature of symptoms is essential for correct coding.
