# Asymmetrical SNHL



## debnance2@icloud.com (Nov 3, 2015)

I need help with coding this particular issue. ICD9 389.16 crosses over to H90.5 but that is really inaccurate, according to my physician. The ICD10 codes appear to overlook mixed hearing loss with SNHL on the contralateral side. An example is patient has mixed hearing loss in the right ear and the left ear has SNHL. ICD10 H90.6 is bilateral mixed. If you choose H90.40 or 41 (laterality) it specifies unrestricted hearing on the contralateral side, which is not correct in this case. 

How would this be coded? Stay with H90.6 ONLY because it covers both ears? Fall back on H90.5 for the left (i.e. H90.6 and H90.5)?


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## JenniferB7 (Nov 3, 2015)

I agree that ICD-10 really made coding hearing loss difficult.   This is from the ASHA (American Speech-Language-Hearing Association):  

How do I appropriately assign ICD-10-CM codes when a patient has hearing loss in both ears?

Unilateral hearing loss codes that include ?unrestricted hearing on the contralateral side? are creating a problem for coding different types of hearing loss in each ear. There is a proposal to the NCHS to add new codes for those times when there is ?restricted hearing on the contralateral side.? However, there will be no revisions until October 2016.

In the meantime, the only way to code two different hearing losses is to use the ?unspecified? hearing loss codes, one for each ear according to the type, as follows:


[*]H90.5 Unspecified sensorineural hearing loss
[*]H90.8 Mixed conductive and sensorineural hearing loss, unspecified
[*]H90.2 Conductive hearing loss, unspecified​

So, in your case, you would use H90.5 for the left ear and H90.8 for the right ear.

Hope this helps!

Jennifer M. Connell, BA, CPC, CENTC, CPCO, CPPM


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## debnance2@icloud.com (Nov 3, 2015)

Huge help! Thanks


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## JenniferB7 (Nov 3, 2015)

You are very welcome!


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## ENTcoderConnecticut (Nov 12, 2015)

Check this out.  CMS has a code lookup tool.

https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx


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