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ICD-10 Guide
ICD-10 CodesChapter 8: Diseases of the ear and mastoid processH91

H91

Non-billable

Other and unspecified hearing loss

Chapter 8:Diseases of the ear and mastoid process

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 H91 is a used to indicate a diagnosis of other and unspecified hearing loss.

Key Diagnostic Point:

The ICD-10 code H91 refers to 'Other and unspecified hearing loss,' which encompasses a variety of auditory impairments that do not fall under more specific categories. This code is used when the exact nature of the hearing loss is not clearly defined or when it includes atypical forms of hearing impairment that do not fit into established classifications. Conditions covered under this category may include mixed hearing loss, sudden sensorineural hearing loss, or other unspecified types of auditory dysfunction. Clinically, it is crucial to identify and document the underlying causes of hearing loss to provide appropriate treatment and management strategies for patients.

  • The clinical significance of accurately coding H91 lies in its implications for patient care and treatment planning. Hearing loss can significantly impact a patient's quality of life, affecting communication, social interactions, and overall well-being. By using this code, healthcare providers can ensure that patients receive the necessary audiological assessments and interventions. Usage guidelines suggest that H91 should be employed when a more specific diagnosis cannot be established, and it is essential for healthcare providers to document any relevant clinical findings that may assist in future evaluations and treatment decisions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation of hearing loss
  • Need for comprehensive audiological assessment
  • Potential overlap with other hearing loss codes

Audit Risk Factors

  • Inadequate documentation of hearing loss type
  • Misuse of unspecified codes
  • Failure to capture the severity of hearing impairment

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Audiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the H91 code category is significant, as it plays a crucial role in understanding and managing hearing loss within the patient population. Accurate coding can influence quality measures related to auditory health, ensuring that patients receive timely and appropriate interventions. From a population health perspective, identifying trends in hearing loss can inform public health initiatives aimed at prevention and early detection, ultimately improving patient outcomes.
Moreover, the use of H91 can affect healthcare trends by highlighting the need for increased awareness and resources dedicated to hearing health. As the population ages, the prevalence of hearing loss is expected to rise, making it imperative for healthcare systems to adapt and provide comprehensive care. By effectively utilizing H91 and related codes, providers can contribute to a more robust understanding of hearing loss and its implications for overall health.

ICD-9 vs ICD-10

The clinical and administrative impact of the H91 code category is significant, as it plays a crucial role in understanding and managing hearing loss within the patient population. Accurate coding can influence quality measures related to auditory health, ensuring that patients receive timely and appropriate interventions. From a population health perspective, identifying trends in hearing loss can inform public health initiatives aimed at prevention and early detection, ultimately improving patient outcomes. Moreover, the use of H91 can affect healthcare trends by highlighting the need for increased awareness and resources dedicated to hearing health. As the population ages, the prevalence of hearing loss is expected to rise, making it imperative for healthcare systems to adapt and provide comprehensive care. By effectively utilizing H91 and related codes, providers can contribute to a more robust understanding of hearing loss and its implications for overall health.

Reimbursement & Billing Impact

Reimbursement considerations may vary by payer, and it is essential to verify coverage policies related to hearing loss evaluations and treatments. Common billing practices include using H91 in conjunction with CPT codes for audiological assessments and interventions, ensuring that all services rendered are justified by the patient's clinical presentation.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for H91

Coding & Billing References

  • •
    Official ICD-10 Guidelines for H91

Frequently Asked Questions

What conditions are included in H91?

H91 includes various forms of hearing loss that are not specifically categorized, such as mixed hearing loss, sudden sensorineural hearing loss, and other unspecified auditory impairments.

When should I use H91 codes?

H91 codes should be used when the specific type of hearing loss is unknown or when it includes atypical presentations that do not fit into more defined categories.

What documentation is required for H91?

Documentation should include a comprehensive audiological evaluation, clinical findings, and any relevant patient history that supports the diagnosis of unspecified hearing loss.