Otolaryngology Coding Alert

How would you handle second-time diagnostic analysis?

The most common diagnosis for cochlear implant patients is 389.10 (Sensorineural hearing loss, unspecified). This condition is usually due to lesions of the cochlea and the auditory division of the eighth cranial nerve. When ICD-9 becomes ICD-10 in October 1, 2013, you will have to shift to coding sensorineural hearing loss using the code H90.5 (Unspecified sensorineural hearing loss).

ICD difference: You wouldn't have to make any adjustment to shifting to the ICD-10 code since the conversion will offer no difference in the code's function. You should notice, too, that 389.10 and H90.5 have the same descriptors.

Coder tips: Suppose a patient had cochlear implant surgery, and your otolaryngologist performed diagnostic analysis. However, this first surgery failed, and the patient underwent a second surgery. You should report the second round of diagnostic analysis with the same CPT codes you must have used to report the first one: 92601-92604 (Diagnostic analysis of cochlear implant ...).

You can attach either 389.10 or 389.18 (Sensorineural hearing loss of combined types) to the procedure code to describe the fitting diagnosis for bilateral sensorineural hearing impairment.

CI patients typically require analysis within six weeks postoperatively for the initial fitting. The patient returns periodically during the first year for adjustments to the processor's stimulus parameters to determine the signals going to surgically implanted electrodes in the cochlea.