Otolaryngology Coding Alert

ICD-10 will help you report the service more accurately.  

When your otolaryngologist removes a foreign body from a patient’s nose or ear, you currently have a single diagnosis code for each situation. That will change after ICD-10’s implementation in 2015, when you’ll have multiple base codes for each anatomic site, plus three options for the seventh character of each code.

ICD-9 choices for foreign body removal (FBR) are: 

• 931 – Foreign body in ear
• 932 – Foreign body in nose. 

Coding notes indicate that 931 includes FBR from the auditory canal or auricle. Diagnosis 932 includes removal from the nasal sinus or nostril. 

Code choices first expand in ICD-10 because of having separate codes for each specific site. Your base codes will be: 

• T16.1xx- : Foreign body in right ear 
• T16.2xx- : Foreign body in left ear 
• T16.9xx- : Foreign body in ear, unspecified ear
• T17.0xx- : Foreign body in nasal sinus 
• T17.1xx- : Foreign body in nostril. 

Refresher: Remember that ICD-10 codes include three to seven characters. The first three characters of an ICD-10 code represent the condition’s category. Characters four, five, and six represent etiology, atomic site, and severity. If the code has seven characters, the seventh represents the visit encounter of sequelae. 

Diagnoses for obstetrics, injuries, and external causes must have seven characters. If the diagnosis you’re submitting doesn’t have options for the fifth or sixth characters you fill the space with an “x” placeholder. 

ICD-10 categories T16 and T17 have three options for the seventh digit: 

• A – Initial encounter 
• D – Subsequent encounter 
• S – Sequela. 

“Initial” encounter is used while the patient is receiving active treatment for the injury. “Subsequent” means the patient has received active treatment for the injury and is now receiving routine care for the injury during the healing or recovery phase. The final option, “sequela,” describes when the patient is fully healed and is returning to the physician for treatment of some type of complication related to the initial condition.