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v1.0.0
ICD-10 Guide
ICD-10 CodesH92.1

H92.1

Billable

Otorrhea

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

Code Description

ICD-10 H92.1 is a billable code used to indicate a diagnosis of otorrhea.

Key Diagnostic Point:

Otorrhea refers to the discharge of fluid from the ear, which can be a symptom of various underlying conditions, particularly infections such as otitis media or otitis externa. The discharge may be purulent, serous, or bloody, and its characteristics can provide clues to the underlying etiology. Otorrhea is often associated with other symptoms such as ear pain, hearing loss, and fever. In cases of otitis media, the fluid may be due to an accumulation of pus behind the eardrum, while in otitis externa, it may result from inflammation of the ear canal. Diagnosis typically involves a thorough clinical examination, including otoscopy, and may require cultures of the discharge to identify infectious agents. Management may include antibiotics for bacterial infections, analgesics for pain relief, and in some cases, surgical interventions such as tympanostomy tubes or drainage procedures. Accurate coding of otorrhea is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (e.g., infections, trauma, foreign bodies)
  • Differentiation between types of discharge (purulent vs. serous)
  • Potential for co-existing conditions (e.g., hearing loss, vestibular disorders)
  • Need for precise documentation of symptoms and treatment

Audit Risk Factors

  • Inadequate documentation of the type and amount of discharge
  • Failure to document associated symptoms (e.g., fever, pain)
  • Misclassification of the underlying cause of otorrhea
  • Lack of follow-up documentation for treatment outcomes

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed notes on the patient's history, physical examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with ear infections, post-operative complications, or chronic ear discharge.

Billing Considerations

Ensure documentation reflects the severity and duration of symptoms to support the diagnosis.

Pediatrics

Documentation Requirements

Thorough history of ear infections, family history, and developmental milestones.

Common Clinical Scenarios

Children with recurrent otitis media or those presenting with otorrhea after swimming.

Billing Considerations

Consider age-related factors in treatment and coding, as pediatric cases may differ significantly from adults.

Coding Guidelines

Inclusion Criteria

Use H92.1 When
  • According to ICD
  • 10 guidelines, H92
  • 1 should be used when the primary symptom is otorrhea
  • It is important to document the underlying cause and any associated conditions to ensure accurate coding

Exclusion Criteria

Do NOT use H92.1 When
  • Exclusion criteria include conditions that do not involve ear discharge

Related ICD-10 Codes

Related CPT Codes

69210CPT Code

Removal of impacted cerumen

Clinical Scenario

When cerumen impaction is causing otorrhea.

Documentation Requirements

Document the presence of cerumen and the procedure performed.

Specialty Considerations

Otolaryngologists may perform this procedure in conjunction with other treatments for otorrhea.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like otorrhea, improving the ability to track and manage ear-related diseases. This specificity aids in better patient care and more accurate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like otorrhea, improving the ability to track and manage ear-related diseases. This specificity aids in better patient care and more accurate reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 otorrhea?

Otorrhea is primarily caused by infections of the ear, such as otitis media or otitis externa, but can also result from trauma or foreign bodies.