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ICD-10 Guide
ICD-10 CodesH90.5

H90.5

Billable

Unspecified sensorineural hearing loss

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

Code Description

ICD-10 H90.5 is a billable code used to indicate a diagnosis of unspecified sensorineural hearing loss.

Key Diagnostic Point:

Unspecified sensorineural hearing loss (H90.5) refers to a type of hearing impairment that arises from damage to the inner ear or the auditory nerve pathways to the brain. This condition can manifest as a gradual or sudden loss of hearing, often affecting the ability to hear certain frequencies or understand speech, particularly in noisy environments. The etiology of sensorineural hearing loss can be multifactorial, including genetic predispositions, exposure to ototoxic medications, aging (presbycusis), viral infections, and noise exposure. Clinically, patients may present with symptoms such as difficulty hearing conversations, tinnitus (ringing in the ears), and a sensation of fullness in the ear. Diagnosis typically involves audiometric testing to assess the degree and type of hearing loss, alongside a thorough patient history and physical examination. Management may include hearing aids, cochlear implants, or other assistive listening devices, depending on the severity and impact on the patient's quality of life. Regular follow-up is essential to monitor the progression of hearing loss and adjust treatment as necessary.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of hearing loss
  • Need for comprehensive audiometric testing for accurate diagnosis
  • Potential overlap with other types of hearing loss (conductive, mixed)
  • Documentation of patient history and risk factors

Audit Risk Factors

  • Inadequate documentation of audiometric results
  • Failure to specify the type of hearing loss when applicable
  • Lack of patient history related to potential risk factors
  • Misclassification of hearing loss type

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric testing results, patient history, and treatment plans.

Common Clinical Scenarios

Evaluation of patients with sudden hearing loss, chronic tinnitus, or age-related hearing decline.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis of unspecified sensorineural hearing loss.

Audiology

Documentation Requirements

Comprehensive audiological assessments and recommendations for hearing aids or other interventions.

Common Clinical Scenarios

Routine hearing evaluations for patients with suspected hearing loss and fitting of hearing aids.

Billing Considerations

Documentation should include patient feedback on hearing aid effectiveness and any changes in hearing status.

Coding Guidelines

Inclusion Criteria

Use H90.5 When
  • According to ICD
  • 10 coding guidelines, H90
  • 5 should be used when the type of sensorineural hearing loss is not specified
  • Coders must ensure that the documentation does not indicate a more specific diagnosis that would warrant a different code

Exclusion Criteria

Do NOT use H90.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used during the evaluation of a patient with suspected sensorineural hearing loss.

Documentation Requirements

Audiometric test results and interpretation must be documented.

Specialty Considerations

Otolaryngologists and audiologists should ensure that all relevant findings are included in the report.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hearing loss types, but H90.5 remains a catch-all for unspecified cases. Coders must be diligent in ensuring that documentation supports the use of this code to avoid denials and audits.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hearing loss types, but H90.5 remains a catch-all for unspecified cases. Coders must be diligent in ensuring that documentation supports the use of this code to avoid denials and audits.

Reimbursement & Billing Impact

reimbursement.

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 should I document to support the use of H90.5?

To support the use of H90.5, document the results of audiometric testing, patient history, and any relevant risk factors or symptoms associated with the hearing loss.