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ICD-10 Guide
ICD-10 CodesH72.811

H72.811

Billable

Multiple perforations of tympanic membrane, right ear

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

Code Description

ICD-10 H72.811 is a billable code used to indicate a diagnosis of multiple perforations of tympanic membrane, right ear.

Key Diagnostic Point:

Multiple perforations of the tympanic membrane (TM) in the right ear can occur due to various etiologies, including chronic otitis media, trauma, or barotrauma. Clinically, patients may present with symptoms such as hearing loss, otorrhea (ear discharge), and ear pain. The tympanic membrane serves as a barrier protecting the middle ear from external pathogens and sound pressure; thus, perforations can lead to complications like recurrent infections and conductive hearing loss. Diagnosis typically involves otoscopic examination, where the physician can visualize the perforations. Audiometric testing may also be conducted to assess the degree of hearing loss. Management strategies may include medical treatment with antibiotics for infections, tympanoplasty for surgical repair, and hearing aids if significant hearing loss persists. The presence of multiple perforations complicates the clinical picture, as it may indicate a more severe underlying condition requiring comprehensive management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of tympanic membrane perforations
  • Understanding the underlying causes of multiple perforations
  • Documenting associated symptoms and complications accurately
  • Navigating the relationship between otitis media and tympanic membrane conditions

Audit Risk Factors

  • Inadequate documentation of the number and size of perforations
  • Failure to document associated conditions like otitis media
  • Misclassification of the type of perforation
  • Lack of clear treatment plans or follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed otoscopic findings, audiometric results, and treatment plans.

Common Clinical Scenarios

Patients presenting with recurrent ear infections, trauma-related perforations, or post-surgical complications.

Billing Considerations

Ensure that all relevant history, including prior treatments and outcomes, is documented to support the diagnosis.

Audiology

Documentation Requirements

Comprehensive audiometric evaluations and reports on hearing loss severity.

Common Clinical Scenarios

Assessment of hearing loss in patients with tympanic membrane perforations.

Billing Considerations

Document the impact of perforations on hearing thresholds and any recommendations for hearing aids or further intervention.

Coding Guidelines

Inclusion Criteria

Use H72.811 When
  • According to ICD
  • 10 coding guidelines, H72
  • 811 should be used when multiple perforations of the tympanic membrane are confirmed through clinical examination
  • Coders must ensure that the right ear is specified and that any associated conditions are documented

Exclusion Criteria

Do NOT use H72.811 When
  • Exclusion criteria include conditions that do not involve perforations or are related to other ear structures

Related ICD-10 Codes

Related CPT Codes

69631CPT Code

Tympanoplasty

Clinical Scenario

Used for surgical repair of multiple tympanic membrane perforations.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

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

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 conditions, including the differentiation between single and multiple perforations, which aids in better tracking and management of ear diseases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, including the differentiation between single and multiple perforations, which aids in better tracking and management of ear diseases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tympanic membrane conditions, including the differentiation between single and multiple perforations, which aids in better tracking and management of ear diseases.

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 causes of multiple perforations of the tympanic membrane?

Common causes include chronic otitis media, trauma, and barotrauma. Each of these conditions can lead to inflammation and damage to the tympanic membrane, resulting in multiple perforations.