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v1.0.0
ICD-10 Guide
ICD-10 CodesH92.02

H92.02

Billable

Otalgia, left ear

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

Code Description

ICD-10 H92.02 is a billable code used to indicate a diagnosis of otalgia, left ear.

Key Diagnostic Point:

Otalgia, or ear pain, is a common symptom that can arise from various underlying conditions affecting the ear and surrounding structures. In the case of H92.02, the pain is specifically localized to the left ear. The etiology of otalgia can range from acute infections such as otitis media or otitis externa to referred pain from dental issues or temporomandibular joint disorders. Patients may present with symptoms such as sharp or dull pain, a sensation of fullness, hearing loss, or discharge from the ear. Diagnostic criteria typically involve a thorough history and physical examination, often supplemented by otoscopic examination to assess for signs of infection or other abnormalities. Management may include analgesics for pain relief, antibiotics for bacterial infections, or referral to an otolaryngologist for further evaluation and treatment. Understanding the underlying cause of otalgia is crucial for effective management and coding, as it may influence the choice of additional codes for coexisting conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of otalgia (primary vs. secondary)
  • Identifying the underlying cause (infection, referred pain, etc.)
  • Potential for coexisting conditions (e.g., hearing loss, sinusitis)
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of the cause of otalgia
  • Failure to specify the laterality of the condition
  • Misuse of codes for related conditions (e.g., otitis media)
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed history of present illness, physical examination findings, and any diagnostic tests performed.

Common Clinical Scenarios

Patients presenting with acute ear pain, chronic otitis media, or complications from ear infections.

Billing Considerations

Ensure to document any surgical interventions or referrals to specialists.

Primary Care

Documentation Requirements

Comprehensive patient history, including onset, duration, and characteristics of pain, as well as any associated symptoms.

Common Clinical Scenarios

Patients with ear pain due to upper respiratory infections or allergies.

Billing Considerations

Document any treatments provided and follow-up plans to support coding.

Coding Guidelines

Inclusion Criteria

Use H92.02 When
  • According to ICD
  • 10 coding guidelines, H92
  • 02 should be used when the primary complaint is ear pain localized to the left ear
  • Coders should ensure that the documentation supports the diagnosis and that any additional conditions are coded appropriately

Exclusion Criteria

Do NOT use H92.02 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

When cerumen impaction is identified as the cause of otalgia.

Documentation Requirements

Document the presence of cerumen impaction and the procedure performed.

Specialty Considerations

Otolaryngologists may perform this procedure in conjunction with other evaluations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding conditions like otalgia, enabling better tracking of ear-related disorders and improving the quality of care through more accurate data collection.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding conditions like otalgia, enabling better tracking of ear-related disorders and improving the quality of care through more accurate data collection.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding conditions like otalgia, enabling better tracking of ear-related disorders and improving the quality of care through more accurate data collection.

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

What is the difference between H92.02 and H92.01?

H92.02 refers specifically to otalgia in the left ear, while H92.01 refers to otalgia in the right ear. Accurate coding requires specifying the laterality of the condition.