ICD-10 Code for External Otitis
The ICD-10 code for external otitis is H60.9 (Unspecified otitis externa).
Understanding External Otitis
- External otitis is defined as an infection of the cutis and subcutis of the external auditory canal (EAC), with variable involvement of the pinna 1
- Clinical presentation includes otalgia, tenderness, fever, and ear discharge 1
- Adults are more commonly affected, with a lifetime incidence of approximately 10% 1
- The most common causative organisms are Pseudomonas aeruginosa and Staphylococcus aureus (98% of cases in North America are bacterial) 1, 2
ICD-10 Code Specificity
- H60.9 is the unspecified code for otitis externa
- More specific codes can be used based on the type and location:
- H60.0 - Abscess of external ear
- H60.1 - Cellulitis of external ear
- H60.2 - Malignant otitis externa
- H60.3 - Other infective otitis externa
- H60.4 - Cholesteatoma of external ear
- H60.5 - Acute otitis externa, non-infective
Clinical Considerations for Coding
- Proper coding is important for:
- Accurate documentation of the condition 3
- Appropriate reimbursement for treatment
- Tracking epidemiological data
- Ensuring continuity of care
Common Variants Requiring Specific Coding
- Necrotizing (malignant) otitis externa (H60.2) - a fulminant infection with extension beyond the EAC, particularly in patients with diabetes or immunosuppression 1, 3
- Fungal otitis externa (H60.391 for right ear, H60.392 for left ear, H60.393 for bilateral) - less common and generally caused by Aspergillus or Candida species 1, 3
- Swimmer's ear (H60.331 for right ear, H60.332 for left ear, H60.333 for bilateral) - common in swimmers due to conversion of normal acidic environment to alkaline 1
Coding Pitfalls to Avoid
- Avoid confusing external otitis (H60 codes) with otitis media (H65-H67 codes), which affects the middle ear 2
- Ensure specificity in coding when the type of external otitis is known (acute, chronic, fungal, etc.) 3
- Document laterality (right, left, bilateral) when using more specific codes 3
- Consider comorbid conditions that may affect treatment choices, such as diabetes or immunosuppression 3
Treatment Considerations
- Diagnosis is largely clinical, and uncomplicated cases can generally be treated with topical antibiotics and analgesics 1, 4
- Topical therapy delivers antimicrobial concentrations 100-1000 times higher than systemic therapy 2
- Oral antibiotics should be reserved for cases with extension beyond the ear canal or in immunocompromised patients 3, 4