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ICD-10 Guide
ICD-10 CodesH70.09

H70.09

Billable

Acute mastoiditis with other complications

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

Code Description

ICD-10 H70.09 is a billable code used to indicate a diagnosis of acute mastoiditis with other complications.

Key Diagnostic Point:

Acute mastoiditis is an infection of the mastoid process, typically resulting from an untreated or inadequately treated acute otitis media. This condition can lead to serious complications, including abscess formation, hearing loss, and the spread of infection to surrounding structures. Clinically, patients may present with symptoms such as ear pain, fever, swelling behind the ear, and drainage from the ear canal. Diagnostic criteria often include imaging studies like CT scans to assess the extent of the infection and any associated complications. Management typically involves antibiotics, and in severe cases, surgical intervention such as mastoidectomy may be necessary to drain abscesses and remove infected tissue. The presence of other complications, such as intracranial involvement or persistent hearing loss, further complicates the clinical picture and management of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute mastoiditis and other ear infections
  • Identifying and documenting associated complications
  • Understanding the need for surgical intervention versus conservative management
  • Navigating the nuances of coding for complications

Audit Risk Factors

  • Inadequate documentation of complications
  • Failure to link the diagnosis to the treatment provided
  • Misclassification of the severity of the condition
  • Lack of clarity in the treatment plan

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure all complications are documented to support the use of H70.09.

Pediatrics

Documentation Requirements

Thorough history and physical examination, including family history of ear infections.

Common Clinical Scenarios

Children with recurrent otitis media leading to mastoiditis.

Billing Considerations

Consider age-related factors in treatment and documentation.

Coding Guidelines

Inclusion Criteria

Use H70.09 When
  • Follow official coding guidelines for acute mastoiditis, ensuring to document the presence of any complications
  • Include relevant clinical findings and treatment details to support the diagnosis

Exclusion Criteria

Do NOT use H70.09 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69436CPT Code

Mastoidectomy

Clinical Scenario

Performed when there is a need to drain abscesses in acute mastoiditis.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Otolaryngology specialists must document the extent of the disease.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acute mastoiditis and its complications, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acute mastoiditis and its complications, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 complications associated with acute mastoiditis?

Common complications include abscess formation, hearing loss, and potential spread of infection to the brain or surrounding structures.