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ICD-10 Guide
ICD-10 CodesH91.01

H91.01

Billable

Ototoxic hearing loss, right ear

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

Code Description

ICD-10 H91.01 is a billable code used to indicate a diagnosis of ototoxic hearing loss, right ear.

Key Diagnostic Point:

Ototoxic hearing loss refers to hearing impairment caused by exposure to ototoxic substances, which can include certain medications, chemicals, or environmental factors. This condition specifically affects the right ear, leading to varying degrees of hearing loss that may be temporary or permanent. Clinically, patients may present with symptoms such as difficulty hearing, tinnitus (ringing in the ears), and a sensation of fullness in the affected ear. Diagnosis typically involves audiometric testing to assess the degree of hearing loss and a thorough patient history to identify potential ototoxic exposures. Management may include discontinuation of the offending agent, hearing aids, or cochlear implants in severe cases. Regular monitoring of hearing function is essential, especially for patients undergoing treatment with known ototoxic medications. The complexity of coding for ototoxic hearing loss arises from the need to accurately document the cause, severity, and specific ear affected, as well as the potential for co-existing conditions such as otitis media or vestibular disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of ototoxic exposure
  • Differentiation from other types of hearing loss
  • Potential for co-existing ear conditions
  • Variability in severity and presentation

Audit Risk Factors

  • Inadequate documentation of ototoxic exposure
  • Failure to specify the affected ear
  • Misclassification of hearing loss type
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed patient history, audiometric test results, and documentation of ototoxic exposure.

Common Clinical Scenarios

Patients presenting with hearing loss after chemotherapy or exposure to ototoxic medications.

Billing Considerations

Ensure clear documentation of the timeline of exposure and onset of symptoms.

Audiology

Documentation Requirements

Comprehensive audiological evaluations and patient history regarding ototoxic exposure.

Common Clinical Scenarios

Assessment of hearing loss in patients with a history of ototoxic drug use.

Billing Considerations

Document the specific tests performed and results to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use H91.01 When
  • According to ICD
  • 10 guidelines, H91
  • 01 should be used when the hearing loss is specifically attributed to ototoxicity in the right ear
  • It is important to document the cause of the ototoxicity and any relevant patient history

Exclusion Criteria

Do NOT use H91.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used when assessing hearing loss in patients with suspected ototoxicity.

Documentation Requirements

Document the results of the audiometric evaluation and any relevant patient history.

Specialty Considerations

Otolaryngologists and audiologists should ensure thorough documentation of the evaluation process.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ototoxic hearing loss, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the cause and affected ear.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ototoxic hearing loss, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the cause and affected ear.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the cause and affected ear.

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 is the primary cause of ototoxic hearing loss?

Ototoxic hearing loss is primarily caused by exposure to certain medications, chemicals, or environmental factors that damage the inner ear structures.