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ICD-10 Guide
ICD-10 CodesH91.03

H91.03

Billable

Ototoxic hearing loss, bilateral

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

Code Description

ICD-10 H91.03 is a billable code used to indicate a diagnosis of ototoxic hearing loss, bilateral.

Key Diagnostic Point:

Ototoxic hearing loss is a type of hearing impairment that occurs as a result of exposure to ototoxic substances, which can include certain medications, chemicals, or environmental factors. Bilateral ototoxic hearing loss affects both ears and can lead to varying degrees of hearing impairment, ranging from mild to profound. Clinically, patients may present with symptoms such as difficulty understanding speech, tinnitus, and a sensation of fullness in the ears. The condition is often diagnosed through audiometric testing, which assesses the degree of hearing loss and can help differentiate it from other types of hearing impairment. Management typically involves identifying and discontinuing the ototoxic agent, providing auditory rehabilitation, and in some cases, utilizing hearing aids or cochlear implants. Regular monitoring of hearing function is essential, especially in patients receiving potentially ototoxic treatments, such as certain chemotherapy agents or high-dose antibiotics. The prognosis varies depending on the extent of exposure and the individual’s response to treatment.

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 conditions affecting hearing
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of ototoxic exposure
  • Failure to include audiometric test results
  • Misclassification of hearing loss type
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of ototoxic exposure, audiometric test results, and treatment plans.

Common Clinical Scenarios

Patients undergoing chemotherapy or those with a history of ototoxic medication use.

Billing Considerations

Ensure clear documentation of the ototoxic agent and its dosage.

Audiology

Documentation Requirements

Comprehensive audiological evaluations and patient history.

Common Clinical Scenarios

Assessment of hearing loss in patients with known ototoxic exposure.

Billing Considerations

Documenting the degree of hearing loss and any rehabilitative measures taken.

Coding Guidelines

Inclusion Criteria

Use H91.03 When
  • According to ICD
  • 10 guidelines, H91
  • 03 should be used when there is clear documentation of bilateral ototoxic hearing loss
  • It is important to include the cause of the ototoxicity and any relevant clinical findings

Exclusion Criteria

Do NOT use H91.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92557CPT Code

Comprehensive audiometry threshold evaluation and speech recognition

Clinical Scenario

Used to assess the degree of hearing loss in patients suspected of ototoxicity.

Documentation Requirements

Audiometric test results must be documented.

Specialty Considerations

Otolaryngologists and audiologists should ensure thorough documentation of findings.

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 ability to track and manage this condition effectively. It emphasizes the importance of detailed documentation regarding the cause of hearing loss.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ototoxic hearing loss, improving the ability to track and manage this condition effectively. It emphasizes the importance of detailed documentation regarding the cause of hearing loss.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ototoxic hearing loss, improving the ability to track and manage this condition effectively. It emphasizes the importance of detailed documentation regarding the cause of hearing loss.

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, such as aminoglycosides, chemotherapy agents like cisplatin, and high doses of salicylates, which can damage the inner ear structures.