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ICD-10 Guide
ICD-10 CodesH72.8

H72.8

Billable

Other perforations of tympanic membrane

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

Code Description

ICD-10 H72.8 is a billable code used to indicate a diagnosis of other perforations of tympanic membrane.

Key Diagnostic Point:

Perforations of the tympanic membrane (TM) can occur due to various reasons, including trauma, infection, or chronic otitis media. The tympanic membrane, also known as the eardrum, plays a crucial role in hearing by transmitting sound vibrations from the outer ear to the middle ear. Other perforations of the tympanic membrane may arise from non-specific causes that do not fit into the more common categories of perforations, such as those resulting from acute otitis media or chronic suppurative otitis media. Clinically, patients may present with symptoms such as hearing loss, otorrhea (ear discharge), tinnitus, and pain. Diagnosis typically involves otoscopic examination, which reveals the size and location of the perforation. Management may include medical treatment with antibiotics if infection is present, or surgical intervention such as tympanoplasty for larger or persistent perforations. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes, particularly in cases where the perforation may lead to complications such as cholesteatoma or further hearing loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of causes leading to perforation
  • Differentiation from other types of tympanic membrane perforations
  • Potential for associated conditions like cholesteatoma
  • Need for detailed documentation of clinical findings

Audit Risk Factors

  • Inadequate documentation of the cause of perforation
  • Failure to document associated symptoms or conditions
  • Incorrect coding of the type of perforation
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes including history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with ear pain, hearing loss, or discharge from the ear.

Billing Considerations

Ensure documentation specifies the cause of perforation and any associated conditions.

Audiology

Documentation Requirements

Audiometric evaluations and reports detailing hearing loss and its impact on daily functioning.

Common Clinical Scenarios

Assessment of hearing loss in patients with known tympanic membrane perforations.

Billing Considerations

Link audiological findings to the diagnosis of tympanic membrane perforation for accurate coding.

Coding Guidelines

Inclusion Criteria

Use H72.8 When
  • According to ICD
  • 10 coding guidelines, H72
  • 8 should be used when the perforation of the tympanic membrane does not fit into more specific categories
  • Coders should ensure that the documentation supports the diagnosis and that all relevant clinical details are included

Exclusion Criteria

Do NOT use H72.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanoplasty

Clinical Scenario

Used for surgical repair of tympanic membrane perforations.

Documentation Requirements

Operative report detailing the procedure and indication for surgery.

Specialty Considerations

Otolaryngology specialists should ensure that the surgical necessity is well documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tympanic membrane perforations, improving the accuracy of data collection and reimbursement processes. H72.8 provides a distinct code for other perforations, which helps in tracking and managing patient outcomes effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tympanic membrane perforations, improving the accuracy of data collection and reimbursement processes. H72.8 provides a distinct code for other perforations, which helps in tracking and managing patient outcomes effectively.

Reimbursement & Billing Impact

reimbursement processes. H72.8 provides a distinct code for other perforations, which helps in tracking and managing patient outcomes effectively.

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 causes of tympanic membrane perforation?

Common causes include trauma, chronic otitis media, and barotrauma. Each cause may require different management strategies.

How is tympanic membrane perforation diagnosed?

Diagnosis is typically made through otoscopic examination, where the size and location of the perforation can be assessed.

What are the treatment options for tympanic membrane perforation?

Treatment options may include observation, medical management with antibiotics, or surgical intervention such as tympanoplasty, depending on the size and cause of the perforation.