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v1.0.0
ICD-10 Guide
ICD-10 CodesH81.0

H81.0

Billable

Ménière's disease

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

Code Description

ICD-10 H81.0 is a billable code used to indicate a diagnosis of ménière's disease.

Key Diagnostic Point:

Ménière's disease is a chronic inner ear disorder characterized by episodes of vertigo, tinnitus, hearing loss, and a sensation of fullness in the ear. The condition is believed to result from abnormal fluid accumulation in the inner ear, which affects the balance and hearing functions. Patients typically experience recurrent episodes of vertigo that can last from 20 minutes to several hours, often accompanied by fluctuating hearing loss that may become permanent over time. Tinnitus, or ringing in the ears, is also a common symptom. The exact cause of Ménière's disease remains unclear, but it may be linked to genetic factors, autoimmune responses, or viral infections. Diagnosis is primarily clinical, based on patient history and symptomatology, often supplemented by audiometric testing and vestibular assessments. Management strategies include dietary modifications, medications for symptom relief, and in some cases, surgical interventions such as endolymphatic sac decompression or vestibular nerve section. The chronic nature of the disease and its impact on quality of life necessitate a comprehensive approach to treatment and ongoing monitoring.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation and severity
  • Need for comprehensive patient history and audiometric testing
  • Potential for co-morbid conditions affecting diagnosis
  • Differentiation from other vestibular disorders

Audit Risk Factors

  • Inadequate documentation of recurrent episodes
  • Failure to document audiometric testing results
  • Lack of clear treatment plans or follow-up notes
  • Misdiagnosis due to overlapping symptoms with other conditions

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed patient history, audiometric test results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with vertigo, tinnitus, and fluctuating hearing loss.

Billing Considerations

Ensure clear documentation of the duration and frequency of episodes for accurate coding.

Neurology

Documentation Requirements

Neurological assessments and differential diagnoses must be documented.

Common Clinical Scenarios

Patients with vestibular symptoms requiring neurological evaluation.

Billing Considerations

Document any neurological findings that may differentiate Ménière's disease from other vestibular disorders.

Coding Guidelines

Inclusion Criteria

Use H81.0 When
  • According to the official coding guidelines, H81
  • 0 should be used when the diagnosis of Ménière's disease is confirmed based on clinical criteria
  • Documentation must support the diagnosis, including symptom duration and frequency, and any relevant audiometric findings

Exclusion Criteria

Do NOT use H81.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69500CPT Code

Endolymphatic sac decompression

Clinical Scenario

Used for patients with refractory Ménière's disease.

Documentation Requirements

Surgical notes and post-operative follow-up must be documented.

Specialty Considerations

Otolaryngology specialists should ensure detailed surgical documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Ménière's disease, improving the accuracy of data collection and reimbursement processes. The detailed coding structure helps in better tracking of the disease's prevalence and management outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Ménière's disease, improving the accuracy of data collection and reimbursement processes. The detailed coding structure helps in better tracking of the disease's prevalence and management outcomes.

Reimbursement & Billing Impact

reimbursement processes. The detailed coding structure helps in better tracking of the disease's prevalence and management outcomes.

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 primary symptoms of Ménière's disease?

The primary symptoms include recurrent episodes of vertigo, tinnitus, fluctuating hearing loss, and a sensation of fullness in the ear.

How is Ménière's disease diagnosed?

Diagnosis is based on clinical history, symptomatology, and audiometric testing to confirm hearing loss.

What are common treatments for Ménière's disease?

Common treatments include dietary changes, medications for symptom relief, and surgical options for refractory cases.