ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesH71.93

H71.93

Billable

Unspecified cholesteatoma, bilateral

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

Code Description

ICD-10 H71.93 is a billable code used to indicate a diagnosis of unspecified cholesteatoma, bilateral.

Key Diagnostic Point:

Cholesteatoma is an abnormal skin growth that can develop in the middle ear and mastoid process, often as a result of chronic ear infections. It can lead to the destruction of surrounding structures and may cause hearing loss, dizziness, and other complications. Bilateral cholesteatomas indicate that the condition affects both ears, which can complicate diagnosis and management. Patients may present with symptoms such as ear discharge, hearing impairment, and a sensation of fullness in the ear. Diagnosis typically involves a thorough clinical examination, audiometric testing, and imaging studies such as CT scans to assess the extent of the disease. Management often requires surgical intervention to remove the cholesteatoma and reconstruct the tympanic membrane, with follow-up care to monitor for recurrence. The unspecified nature of this code indicates that the specific characteristics of the cholesteatoma have not been detailed, which may affect treatment planning and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for detailed documentation of ear examinations
  • Potential for co-existing conditions affecting coding
  • Variations in surgical interventions and follow-up care

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of cholesteatoma
  • Lack of supporting imaging studies
  • Inconsistent coding of related ear conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed notes on ear examinations, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic ear infections, hearing loss, or post-surgical follow-up.

Billing Considerations

Ensure clear documentation of the extent of cholesteatoma and any associated complications.

Audiology

Documentation Requirements

Audiometric evaluations and hearing assessments.

Common Clinical Scenarios

Patients with hearing loss secondary to cholesteatoma.

Billing Considerations

Document the impact of cholesteatoma on hearing and any recommended interventions.

Coding Guidelines

Inclusion Criteria

Use H71.93 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's bilateral nature and any associated symptoms
  • existing

Exclusion Criteria

Do NOT use H71.93 When
  • Exclude codes for other specific ear conditions unless they are co

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanomastoid surgery

Clinical Scenario

Performed for removal of cholesteatoma and reconstruction of the tympanic membrane.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Otolaryngology specialists should ensure comprehensive documentation of the surgical approach and post-operative care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cholesteatomas, improving the accuracy of diagnosis and treatment tracking. The introduction of bilateral codes helps in understanding the prevalence and management of this condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cholesteatomas, improving the accuracy of diagnosis and treatment tracking. The introduction of bilateral codes helps in understanding the prevalence and management of this condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cholesteatomas, improving the accuracy of diagnosis and treatment tracking. The introduction of bilateral codes helps in understanding the prevalence and management of this condition.

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 symptoms of bilateral cholesteatoma?

Common symptoms include ear discharge, hearing loss, a feeling of fullness in the ear, dizziness, and tinnitus. Patients may also experience complications related to the condition.

How is cholesteatoma diagnosed?

Diagnosis typically involves a clinical examination, audiometric testing, and imaging studies such as CT scans to assess the extent of the cholesteatoma.