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ICD-10 Guide
ICD-10 CodesH70.013

H70.013

Billable

Subperiosteal abscess of mastoid, bilateral

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

Code Description

ICD-10 H70.013 is a billable code used to indicate a diagnosis of subperiosteal abscess of mastoid, bilateral.

Key Diagnostic Point:

A subperiosteal abscess of the mastoid is a localized collection of pus that forms beneath the periosteum of the mastoid process, typically as a complication of acute or chronic otitis media. This condition is characterized by inflammation and infection that can lead to significant morbidity if not treated promptly. Bilateral involvement indicates that both mastoid processes are affected, which can complicate the clinical picture and management. Patients may present with symptoms such as fever, ear pain, swelling behind the ear, and hearing loss. Physical examination may reveal tenderness over the mastoid area and possible drainage from the ear. Diagnostic imaging, such as CT scans, is often utilized to confirm the diagnosis and assess the extent of the abscess. Management typically involves antibiotics and may require surgical intervention, such as mastoidectomy, to drain the abscess and prevent further complications, including meningitis or intracranial abscesses. Early recognition and treatment are crucial to prevent serious sequelae.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Bilateral nature complicates coding and documentation.
  • Requires clear differentiation from other types of mastoiditis.
  • Potential for multiple related diagnoses (e.g., otitis media).
  • Need for precise documentation of clinical findings and imaging results.

Audit Risk Factors

  • Inadequate documentation of bilateral involvement.
  • Failure to document the clinical rationale for surgical intervention.
  • Misclassification of the type of mastoiditis.
  • Lack of imaging reports to support diagnosis.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including symptoms, examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with ear pain, fever, and swelling behind the ear, requiring surgical intervention.

Billing Considerations

Ensure clear documentation of the bilateral nature and any surgical procedures performed.

Pediatrics

Documentation Requirements

Thorough history and physical examination, including developmental milestones and any prior ear infections.

Common Clinical Scenarios

Children with recurrent otitis media leading to complications such as mastoid abscess.

Billing Considerations

Consider age-related factors in treatment and coding, as pediatric cases may differ in presentation.

Coding Guidelines

Inclusion Criteria

Use H70.013 When
  • Follow official ICD
  • CM guidelines for coding abscesses and infections
  • Ensure accurate documentation of the bilateral nature and any associated conditions
  • The code should be used when the abscess is confirmed through clinical evaluation and imaging

Exclusion Criteria

Do NOT use H70.013 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Mastoidectomy

Clinical Scenario

Performed to drain a bilateral mastoid abscess.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Otolaryngologists must document the extent of the abscess and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of conditions like bilateral subperiosteal abscesses, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of conditions like bilateral subperiosteal abscesses, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of conditions like bilateral subperiosteal abscesses, improving data accuracy and facilitating better patient management.

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 hearing loss. Patients may also exhibit signs of systemic infection.