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ICD-10 Guide
ICD-10 CodesH70.011

H70.011

Billable

Subperiosteal abscess of mastoid, right ear

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

Code Description

ICD-10 H70.011 is a billable code used to indicate a diagnosis of subperiosteal abscess of mastoid, right ear.

Key Diagnostic Point:

A subperiosteal abscess of the mastoid process is a localized collection of pus that forms beneath the periosteum of the mastoid bone, typically as a complication of acute otitis media or chronic otitis media. This condition is characterized by inflammation and infection that can lead to significant morbidity if not treated promptly. Patients often present with symptoms such as ear pain, fever, and swelling behind the ear. Physical examination may reveal tenderness over the mastoid area, and in some cases, the ear may protrude outward due to the swelling. Diagnostic imaging, such as a CT scan, is often utilized to confirm the presence of the abscess and assess its extent. Management typically involves antibiotic therapy and may require surgical intervention, such as mastoidectomy or drainage of the abscess, to prevent further complications like hearing loss or intracranial spread of infection. Early recognition and treatment are crucial to prevent serious outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute and chronic conditions
  • Need for precise documentation of symptoms and imaging results
  • Potential for multiple related diagnoses (e.g., otitis media)
  • Variability in treatment approaches (medical vs. surgical)

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document imaging results
  • Incorrect coding of associated conditions (e.g., otitis media)
  • Lack of clarity on the surgical procedure performed

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed notes on patient history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Management of acute mastoiditis, drainage of abscesses, and post-operative care.

Billing Considerations

Ensure clear documentation of the extent of infection and any complications.

Pediatrics

Documentation Requirements

Thorough documentation of symptoms, family history, and any prior ear infections.

Common Clinical Scenarios

Children presenting with recurrent ear infections leading to mastoid complications.

Billing Considerations

Consider age-related factors in treatment and coding.

Coding Guidelines

Inclusion Criteria

Use H70.011 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated diagnoses
  • Include details about the patient's history of ear infections and any imaging studies performed

Exclusion Criteria

Do NOT use H70.011 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69420CPT Code

Mastoidectomy, simple

Clinical Scenario

Used when surgical intervention is required for drainage of the abscess.

Documentation Requirements

Document the indication for surgery, findings during the procedure, and post-operative care.

Specialty Considerations

Otolaryngologists must ensure that all surgical notes are detailed and correlate with the diagnosis.

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 subperiosteal abscesses, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like subperiosteal abscesses, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like subperiosteal abscesses, improving the accuracy of patient records and facilitating better tracking of treatment outcomes.

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 are the common symptoms of a subperiosteal abscess of the mastoid?

Common symptoms include ear pain, fever, swelling behind the ear, and possible drainage from the ear. Patients may also experience hearing loss or headache.