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ICD-10 Guide
ICD-10 CodesH91.13

H91.13

Billable

Presbycusis, bilateral

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

Code Description

ICD-10 H91.13 is a billable code used to indicate a diagnosis of presbycusis, bilateral.

Key Diagnostic Point:

Presbycusis is a type of age-related hearing loss that affects both ears and is characterized by a gradual decline in hearing ability. It typically manifests as difficulty in hearing high-frequency sounds, understanding speech in noisy environments, and an overall reduction in sound clarity. The condition is primarily due to the degeneration of hair cells in the cochlea, changes in the auditory nerve, and alterations in the central auditory pathways. Patients may also experience tinnitus, which can accompany the hearing loss. The onset of presbycusis is usually insidious, making it challenging for individuals to recognize the decline in their hearing ability until it significantly impacts their daily life. Diagnosis is often made through audiometric testing, which assesses the degree of hearing loss and helps differentiate presbycusis from other types of hearing impairment. Management may include hearing aids, auditory rehabilitation, and counseling to help patients adapt to their hearing loss. Regular monitoring and follow-up are essential to adjust treatment as the condition progresses.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Age-related nature of the condition complicates documentation.
  • Differentiation from other types of hearing loss is necessary.
  • Requires comprehensive audiometric testing results.
  • Potential for co-existing conditions affecting hearing.

Audit Risk Factors

  • Inadequate documentation of audiometric test results.
  • Failure to specify bilateral involvement.
  • Misclassification of presbycusis as conductive hearing loss.
  • Lack of follow-up documentation on treatment efficacy.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric evaluations and patient history.

Common Clinical Scenarios

Patients presenting with gradual hearing loss, difficulty in noisy environments, and tinnitus.

Billing Considerations

Ensure documentation reflects the bilateral nature and age-related aspects of the hearing loss.

Audiology

Documentation Requirements

Comprehensive audiological assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing hearing evaluations and fitting for hearing aids.

Billing Considerations

Document the specific type and degree of hearing loss, including patient-reported outcomes.

Coding Guidelines

Inclusion Criteria

Use H91.13 When
  • According to ICD
  • 10 guidelines, presbycusis is classified under diseases of the ear and mastoid process
  • It is essential to document the bilateral nature of the condition and any associated symptoms

Exclusion Criteria

Do NOT use H91.13 When
  • Exclusion criteria include conductive hearing loss and other specific types of hearing impairment

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 presbycusis.

Documentation Requirements

Audiometric test results must be documented, including thresholds for air and bone conduction.

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. This specificity aids in research and improves patient care by allowing for tailored treatment plans.

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. This specificity aids in research and improves patient care by allowing for tailored treatment plans.

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. This specificity aids in research and improves patient care by allowing for tailored treatment plans.

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 presbycusis?

Presbycusis is primarily caused by age-related degeneration of the auditory system, including hair cell loss in the cochlea and changes in the auditory nerve.