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v1.0.0
ICD-10 Guide
ICD-10 CodesH91.9

H91.9

Billable

Unspecified hearing loss

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

Code Description

ICD-10 H91.9 is a billable code used to indicate a diagnosis of unspecified hearing loss.

Key Diagnostic Point:

Unspecified hearing loss refers to a reduction in the ability to hear sounds without a specific diagnosis or etiology. This condition can manifest as a partial or complete inability to hear in one or both ears. Patients may present with symptoms such as difficulty understanding speech, asking for repetition, or needing to increase the volume of audio devices. The causes of hearing loss can be diverse, including age-related changes, noise exposure, ototoxic medications, infections, or congenital factors. Diagnostic evaluation typically involves audiometric testing, which assesses the degree and type of hearing loss, and may include imaging studies if a structural abnormality is suspected. Management strategies vary based on the underlying cause but may include hearing aids, cochlear implants, or surgical interventions for conditions like otosclerosis or chronic otitis media. Given the broad nature of this code, it is essential for healthcare providers to document any relevant clinical findings and patient history to support the diagnosis and ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Broad definition leading to varied interpretations
  • Potential overlap with other hearing loss codes
  • Need for comprehensive documentation to support unspecified diagnosis
  • Variability in clinical presentation and management

Audit Risk Factors

  • Inadequate documentation supporting the unspecified diagnosis
  • Failure to provide audiometric test results
  • Lack of follow-up or management plans in the medical record
  • Use of this code without a clear clinical rationale

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed audiometric evaluations, patient history, and physical examination findings.

Common Clinical Scenarios

Patients presenting with hearing loss of unknown origin, post-otitis media complications, or age-related hearing changes.

Billing Considerations

Ensure that all diagnostic tests and their results are documented to support the unspecified hearing loss diagnosis.

Audiology

Documentation Requirements

Comprehensive audiological assessments, including pure-tone audiometry and tympanometry results.

Common Clinical Scenarios

Patients undergoing routine hearing evaluations or those referred for further assessment of hearing loss.

Billing Considerations

Document the rationale for recommending hearing aids or other interventions based on the audiological findings.

Coding Guidelines

Inclusion Criteria

Use H91.9 When
  • According to ICD
  • 10 guidelines, H91
  • 9 should be used when the specific cause of hearing loss is not documented
  • Coders must ensure that the medical record reflects the patient's clinical presentation and any diagnostic tests performed
  • If a more specific diagnosis is available, it should be used instead

Exclusion Criteria

Do NOT use H91.9 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 a patient presents with hearing loss for evaluation.

Documentation Requirements

Audiometric test results and patient history must be documented.

Specialty Considerations

Otolaryngologists and audiologists should ensure that the rationale for testing is clearly stated.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding hearing loss, but the use of H91.9 remains common due to the broad nature of the code. Coders must be diligent in documenting the clinical rationale for using this code to avoid potential audit issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding hearing loss, but the use of H91.9 remains common due to the broad nature of the code. Coders must be diligent in documenting the clinical rationale for using this code to avoid potential audit issues.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding hearing loss, but the use of H91.9 remains common due to the broad nature of the code. Coders must be diligent in documenting the clinical rationale for using this code to avoid potential audit issues.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should H91.9 be used?

H91.9 should be used when a patient presents with hearing loss, and the specific cause is not documented or identified after a thorough evaluation.