Otolaryngology Coding Alert

The fifth digit makes all the difference.

Simply put, otalgia refers to an earache. In infants, this is often indicated by children tugging on their ears, and older patients present complaining of ear pain to the physician. ENTs often report otalgia diagnoses when patients complain of ear pain but no more definitive diagnosis is found.

ICD-9 to ICD-10: Currently, you should use 388.70 (Otalgia, unspecified). However, that changes for ICD-10. You’ll have these four options:

• H92.01 (Otalgia, right ear)
• H92.02 (Otalgia, left ear)
• H92.03 (Otalgia, bilateral)
• H92.09 (Otalgia, unspecified ear).

What makes these diagnoses unique from each other is the anatomical location(s).

Documentation: Physicians should already include the affected ear in their documentation. All you need to do as a coder to capture this already present information is to format your superbill to ensure that physicians document the additional anatomical information.

Tip: You can organize your superbill in a way that ensures that the physician documents all information applicable for you to submit the most accurate diagnosis code. For instance, you can print it like this:

H92.0x (x=1 for right ear, x=2 for left ear, x=3 for bilateral, and x=9 for unspecified ear)

Or you can simply list "H92.0x" and have the physician circle "left ear," "right ear," or "bilateral" on the form