Otolaryngology Coding Alert

Heads up: You’ll need to know more specifics about affected sites.

Physicians diagnose Meniere’s disease by assessing a patient’s symptoms and eliminating other potential conditions (see “Know When Symptoms Move From Vertigo to Meniere’s Disease for Accurate Coding” on page 74). Read on to ensure you’re assigning the correct diagnosis codes now and to get a heads-up on how you’ll code under ICD-10.

Common symptoms the otolaryngologist rules out on his way to a Meniere’s disease diagnosis include:

Vertigo (386.2, Vertigo of central origin)

Unilateral, low frequency hearing loss (389.8, Other specified forms of hearing loss)

Tinnitus (388.3x, Tinnitus)

Aural fullness (388.8, Other disorders of ear).

The diagnosis for Meniere’s disease itself falls under 386.0x. Choose the appropriate code based on the status of disease and the affected site:

• 386.00 – Meniere’s disease, unspecified
• 386.01 – Active Meniere’s disease, cochleovestibular
• 386.02 – Active Meniere’s disease, cochlear
• 386.03 – Active Meniere’s disease, vestibular
• 386.04 – Inactive Meniere’s disease.

ICD-10 changes: Here’s how you’ll report the same symptoms and a Meniere’s disease diagnosis when ICD-10 goes into effect in October 2014:

Vertigo: H81.4x (Vertigo of central origin) with the fifth digit representing right, left, bilateral, or unspecified

Unilateral, low frequency hearing loss: H91.8X1 (Other specified hearing loss, right ear), H91.8X2 (Other specified hearing loss, left ear), and H91.8X3 (Other specified hearing loss, bilateral)

Tinnitus: The current diagnosis codes for tinnitus are classified as unspecified (388.30), subjective (388.31), or objective (388.32). ICD-10 will categorize tinnitus by laterality under H93.1x. The final digit will designate right, left, bilateral, or unspecified.

Coding help: Your provider should already be accustomed to documenting the anatomic site affected by Meniere’s disease and the type of vertigo or tinnitus the patient is experiencing. When you begin coding with ICD-10, documentation will need to include notes related to the symptom’s or condition’s laterality.