Otolaryngology Coding Alert

ICD-10 won’t cover all options, so you could turn to ‘unspecified’ more often.

Many of your current diagnosis codes will be expanded or more specific when you transition to ICD-10 in October, but a big exception for otolaryngology is with conductive hearing loss.

ICD-9 options: In ICD-9, conductive hearing loss diagnoses are specific to the location within the ear under category 389.0x (Conductive hearing loss). For example, a few of your current choices include:

• 389.01 – Conductive hearing loss, external ear
  
• 389.02 – Conductive hearing loss, tympanic membrane
  
• 389.03 – Conductive hearing loss, middle ear
  
• 389.05 – Conductive hearing loss, unilateral
  
• 389.06 – Conductive hearing loss, bilateral.
  

If you don’t know details about the area affected by hearing loss, you report 389.00 (Conductive hearing loss unspecified).

ICD-10 changes: The descriptors under ICD-10 will focus on the affected ear rather than the specific anatomic site of hearing loss. For example, your standard options will be:

• H90.0 – Conductive hearing loss, bilateral
  
• H90.11 – Conductive hearing loss, unilateral, right ear, with unrestricted hearing loss in the contralateral ear
  
• H90.12 – Conductive hearing loss, unilateral, left ear, with unrestricted hearing loss in the contralateral ear
  
• H90.2 – Conductive hearing loss, unspecified.
  

Important: Currently, ICD-10 does not include codes for different types of hearing loss in each ear (such as conductive loss in the left ear and sensorineural loss in the right). Additional codes to address these situations have been requested, but officials say there won’t be any changes for 2014.

Solution: When reporting mixed hearing loss under ICD-10, you’ll submit H90.2 for “unspecified” until more codes are available.

Documentation tips: Your physicians and other providers hopefully already are in the habit of documenting which ear has experienced conductive hearing loss. If not, they’ll need to start adding that detail so you can assign the correct ICD-10 diagnosis. Otherwise, you’ll be relegated to submitting “unspecified” on a regular basis.