Otolaryngology Coding Alert

The updated descriptor is basically the same.

One diagnosis that hasn’t had much change in the shift from ICD-9 to ICD-10 is unspecified sensorineural hearing loss.

The ICD-19 code of 389.10 (Sensorineural hearing loss, unspecified) has changed to H90.5 (Unspecified sensorineural hearing loss).

Documentation: It might be appropriate to report H90.5 when you see the following symptoms noted by your physician:

• Certain sounds seem too loud
• Difficulty following conversations when two or more people are talking
• Difficulty hearing in noisy areas
• Easier to hear men's voices than women's voices
• Hard to tell high-pitched sounds (such as “s” or “th”) from one another
• Other people's voices sound mumbled or slurred
• Problems hearing when there is background noise.

Just the same, never assume. Don’t report sensorineural hearing loss unless your physician specifically states that the patient has the condition.

Coder tips: Suppose a patient had cochlear implant (CI) surgery, and your otolaryngologist performed diagnostic analysis. However, this first surgery failed, and the patient underwent a second surgery. You should report the second round of diagnostic analysis with the same CPT^® codes you must have used to report the first one: 92601-92604 (Diagnostic analysis of cochlear implant ...).

You can include either H90.5 or H90.3 (Sensorineural hearing loss, bilateral) with the procedure code to describe the fitting diagnosis for bilateral sensorineural hearing impairment.

CI patients typically require analysis within six weeks postoperatively for the initial fitting. The patient returns periodically during the first year for adjustments to the processor’s stimulus parameters to determine the signals going to surgically implanted electrodes in the cochlea.

Definition: Sensorineural deafness occurs from damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain. This condition is usually due to lesions of the cochlea and the auditory division of the eighth cranial nerve.