Pediatric Coding Alert

Question: My pediatrician documented otitis media with effusion (OME) for one patient, and chronic otitis media with effusion (COME) for another. What is the difference, and how do I code them?

Texas Subscriber

Answer: To find the precise codes for these common conditions, you’ll need to go to the ICD-10 index.

OME occurs when the acute otitis media (AOM) is over, but fluid still exists and is visible behind the ear drum. The condition is also known as serous OM. The alphabetic index tells you look to otitis, media, nonsuppurative to find otitis (acute) with effusion, which leads you to H65.9- (Unspecified nonsuppurative otitis media).

COME occurs when the middle ear fluid remains over time without an infection present in the patient. For this condition, the index tells you go to otitis, media, nonsuppurative, chronic, which leads you to use H65.49- (Other chronic nonsuppurative otitis media). Here, you’ll see the synonym “chronic otitis media with effusion (nonpurulent),” confirming you have the right code for the condition.