ICD-10 Codes for Hearing Loss
The ICD-10 coding system for hearing loss uses the H90-H91 series for sensorineural, conductive, and mixed hearing loss, with specific codes determined by laterality (bilateral, unilateral right, unilateral left, or unspecified) and type of hearing loss.
Primary ICD-10 Code Categories
The main diagnostic codes for hearing loss include:
Sensorineural Hearing Loss (H90.3-H90.5)
- H90.3: Sensorineural hearing loss, bilateral
- H90.41: Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
- H90.42: Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
- H90.5: Unspecified sensorineural hearing loss
Conductive Hearing Loss (H90.0-H90.2)
- H90.0: Conductive hearing loss, bilateral
- H90.11: Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
- H90.12: Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
- H90.2: Unspecified conductive hearing loss
Mixed Hearing Loss (H90.6-H90.8)
- H90.6: Mixed conductive and sensorineural hearing loss, bilateral
- H90.71: Mixed conductive and sensorinenal hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
- H90.72: Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
- H90.8: Mixed conductive and sensorineural hearing loss, unspecified
Age-Related Hearing Loss
- H91.1: Presbycusis (age-related hearing loss) - specifically for progressive bilateral sensorineural hearing loss in persons ≥50 years old 1
Clinical Context for Code Selection
When selecting the appropriate ICD-10 code, you must document:
- Type of hearing loss: Sensorineural (inner ear/nerve), conductive (outer/middle ear), or mixed 2
- Laterality: Bilateral versus unilateral (right or left ear)
- Age of onset: Congenital, prelingual, postlingual, or age-related 2
- Severity: Mild (26-40 dB), moderate (41-55 dB), moderately severe (56-70 dB), severe (71-90 dB), or profound (≥91 dB) 2
Common Pitfalls
Critical coding error: Using unspecified codes (H90.5, H90.2, H90.8) when laterality and type are known from audiometric testing reduces coding accuracy and may affect reimbursement 3. Always obtain or refer for an audiogram to establish the specific type and laterality of hearing loss 1.
For syndromic hearing loss: Use additional codes to capture associated conditions (e.g., Pendred syndrome, Usher syndrome, Waardenburg syndrome) as these represent approximately 30% of genetic hearing loss cases 2.
For sudden sensorineural hearing loss: Consider H91.2 codes for sudden idiopathic hearing loss, which requires different management protocols 4.
The ICD-10 system transitioned in the United States in 2015, and accurate coding is essential not only for reimbursement but also for tracking mortality and morbidity statistics globally 3.