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ICD-10 Guide
ICD-10 CodesH91.12

H91.12

Billable

Presbycusis, left ear

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

Code Description

ICD-10 H91.12 is a billable code used to indicate a diagnosis of presbycusis, left ear.

Key Diagnostic Point:

Presbycusis is a type of age-related hearing loss that typically affects both ears, but in this case, it is specifically noted for the left ear. It is characterized by a gradual decline in hearing ability, primarily affecting the ability to hear high-frequency sounds. This condition is often due to changes in the inner ear structures, including hair cell loss, degeneration of the cochlea, and changes in the auditory nerve pathways. Patients may present with difficulty understanding speech, especially in noisy environments, and may experience a sensation of fullness in the ear. Diagnosis is usually made through audiometric testing, which reveals a characteristic pattern of hearing loss. Management may include hearing aids, auditory rehabilitation, and counseling. It is important to differentiate presbycusis from other types of hearing loss, such as conductive or sensorineural hearing loss due to other etiologies, to ensure appropriate treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of hearing loss
  • Age-related factors influencing presentation
  • Need for audiometric testing documentation
  • Potential co-morbidities affecting hearing

Audit Risk Factors

  • Inadequate documentation of audiometric results
  • Failure to specify laterality
  • Misdiagnosis of presbycusis as conductive hearing loss
  • Lack of evidence for age-related changes

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric testing results, patient history, and physical examination findings.

Common Clinical Scenarios

Evaluation of elderly patients presenting with hearing difficulties, management of hearing aids.

Billing Considerations

Ensure documentation reflects the gradual nature of hearing loss and its impact on daily living.

Audiology

Documentation Requirements

Comprehensive audiological assessments, including pure-tone audiometry and speech recognition scores.

Common Clinical Scenarios

Routine hearing evaluations in aging populations, fitting and follow-up of hearing aids.

Billing Considerations

Document the specific frequencies affected and the patient's communication challenges.

Coding Guidelines

Inclusion Criteria

Use H91.12 When
  • Follow the ICD
  • CM guidelines for coding hearing loss, ensuring to document the specific type and laterality
  • Presbycusis is classified under diseases of the ear and mastoid process, and proper coding requires clear documentation of the condition's chronic nature

Exclusion Criteria

Do NOT use H91.12 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 presbycusis.

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 presbycusis, enabling better tracking of age-related hearing loss and its management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of presbycusis, enabling better tracking of age-related hearing loss and its management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of presbycusis, enabling better tracking of age-related hearing loss and its management.

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 presbycusis?

Presbycusis is age-related hearing loss that typically affects both ears, characterized by a gradual decline in hearing ability, particularly for high-frequency sounds.

How is presbycusis diagnosed?

Diagnosis is made through audiometric testing, which reveals a characteristic pattern of hearing loss associated with aging.

What are the treatment options for presbycusis?

Management may include hearing aids, auditory rehabilitation, and counseling to help patients cope with hearing loss.