Otolaryngology Coding Alert

The ICD-10 code for hearing loss will retain its old descriptor.

When a patient suffers from Ménière's disease (386.00, Ménière's disease unspecified), she would usually present to the office complaining of hearing loss, pressure in the ear, tinnitus, severe imbalance, and vertigo. This symptoms result from nonsuppurative disease of the labyrinth; swelling of the endolymph-containing structures is the main pathologic finding. Beginning Oct. 1, 2013, you will report this condition with ICD-10 code H81.09 (Ménière's disease, unspecified ear).

ICD-10-CM difference: Ménière's disease's unspecified ICD-9-CM and ICD-10-CM codes share the same descriptor, with H81.09 deriving from its parent code H81.0x (Ménière's disease) the applicability to labyrinthine hydrops, and Ménière's syndrome or vertigo. Additional three codes under H81.0 (besides H81.09) describe the condition in greater detail:

• H81.01 -- ... right ear
• H81.02 -- ... left ear
• H81.03 -- ... bilateral.

Warning: As with ICD-9, you should avoid reporting unspecified codes as much as possible. Submitting H81.09 (an unspecified code) tells the payer you're not sure if the Ménière's disease occured in the right ear, left ear, or both. That may signal an audit.

Coding tips: Be on the lookout for other names that your physician may use to refer to Ménière's disease. These include: endolymphatic hydrops, Lermoyez syndrome, Ménière's syndrome (if secondary to known cause). All these terms should lead you to the same ICD-10 code: H81.0x.