Otolaryngology Coding Alert

Your providers will need to document laterality beginning in October.

With warm weather approaching, your otolaryngologist could begin seeing more patients because of swimmer’s ear, otherwise known as otitis externa. You currently report the diagnosis with 380.12 (Acute swimmer’s ear). Other terms your provider might use for otitis externa include “beach ear” or “tank ear.” 

ICD-10 update: You’ll have more detailed choices for a diagnosis when ICD-10 goes into effect in October. The following options will apply: 

• H60.331 – Swimmer’s ear, right ear 

• H60.332 – Swimmer’s ear, left ear

• H60. 333 – Swimmer’s ear, bilateral 

• H60.339 – Swimmer’s ear, unspecified ear. 

Because the new diagnoses will specify laterality, your providers will need to document which ear they treat. If not, you’ll need to report H60.339. 

Diagnosis: Your otolaryngologist would normally diagnose acute swimmer’s ear by physical examination. However, a sample of the discharge may be submitted to the laboratory for culture and sensitivity testing. A culture spots the organism (pathogen) that causes the infection. Sensitivity indicates the most appropriate antibiotic for treatment. 

Coder tips: Otolaryngologists would sometimes treat conditions such as otitis externa and diffuse acute otitis externa (H60.00, Abscess of external ear, unspecified ear; H60.10, Cellulitis of external ear, unspecified ear; H60.319, Diffuse otitis externa, unspecified ear; H60.329, Hemorrhagic otitis externa, unspecified ear; and H60.399, Other infective otitis externa, unspecified ear) by ear wick placement — a surgical procedure. This procedure involves a physician applying liquid medication to a sterile, compressed sponge, which gently and evenly expands to fill the ear canal, dispersing the medication and applying gentle pressure to the tissue. He then inserts the sponge gently, usually under direct visualization, taking care not to push it in too deep