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ICD-10 Guide
ICD-10 CodesH91.2

H91.2

Billable

Sudden idiopathic hearing loss

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

Code Description

ICD-10 H91.2 is a billable code used to indicate a diagnosis of sudden idiopathic hearing loss.

Key Diagnostic Point:

Sudden idiopathic hearing loss (SIHL) is characterized by a rapid onset of hearing loss, typically occurring over a period of 72 hours or less, without an identifiable cause. This condition can affect one or both ears and is often accompanied by symptoms such as tinnitus (ringing in the ears) and a sensation of fullness in the affected ear. The exact etiology remains unclear, but potential contributing factors include viral infections, vascular issues, autoimmune disorders, and stress. Diagnosis is primarily clinical, supported by audiometric testing to confirm the degree and type of hearing loss. Imaging studies may be warranted to rule out structural abnormalities or other causes. Management often involves corticosteroids to reduce inflammation and promote recovery, although the efficacy of treatment varies. Early intervention is crucial, as prompt treatment may improve outcomes. SIHL can significantly impact quality of life, necessitating a multidisciplinary approach for comprehensive care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptomatology
  • Need for differential diagnosis to rule out other causes of hearing loss
  • Potential overlap with other hearing loss codes
  • Documentation requirements for idiopathic nature

Audit Risk Factors

  • Inadequate documentation of the idiopathic nature of the hearing loss
  • Failure to document the onset and progression of symptoms
  • Lack of supporting audiometric testing results
  • Misclassification with other types of hearing loss codes

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of hearing loss onset, audiometric test results, and treatment plans.

Common Clinical Scenarios

Patients presenting with sudden hearing loss, tinnitus, or ear fullness.

Billing Considerations

Ensure clear documentation of the idiopathic nature and any ruling out of other conditions.

Audiology

Documentation Requirements

Comprehensive audiological evaluations and patient history.

Common Clinical Scenarios

Patients undergoing hearing assessments for sudden hearing loss.

Billing Considerations

Document all findings and recommendations for further management or referral.

Coding Guidelines

Inclusion Criteria

Use H91.2 When
  • According to ICD
  • 10 guidelines, H91
  • 2 should be used when the hearing loss is sudden and idiopathic, with no identifiable cause
  • Coders must ensure that the diagnosis is supported by clinical documentation and audiometric testing

Exclusion Criteria

Do NOT use H91.2 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 with sudden hearing loss.

Documentation Requirements

Audiometric test results and patient history.

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 hearing loss conditions, including SIHL, which enhances the ability to track and manage these cases effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hearing loss conditions, including SIHL, which enhances the ability to track and manage these cases effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hearing loss conditions, including SIHL, which enhances the ability to track and manage these cases effectively.

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 treatment for sudden idiopathic hearing loss?

The primary treatment for sudden idiopathic hearing loss is corticosteroid therapy, which may help reduce inflammation and improve hearing outcomes. Early intervention is crucial for the best results.