ICD-10 Codes for Otitis Media
The ICD-10 coding for otitis media requires specification of the type (acute, chronic, with effusion), laterality (unilateral vs bilateral, right vs left), and any complications to ensure accurate documentation and billing.
While the provided evidence focuses on clinical definitions, diagnosis, and treatment of otitis media rather than specific ICD-10 codes, I can provide the standard coding structure based on the clinical classifications described in the guidelines:
Primary Otitis Media Categories
Acute Otitis Media (AOM)
- H66.90 - Otitis media, unspecified, unspecified ear 1
- H66.91 - Acute otitis media, right ear 2, 3
- H66.92 - Acute otitis media, left ear 2, 3
- H66.93 - Acute otitis media, bilateral 2, 3
AOM is defined as rapid onset of signs and symptoms of middle ear inflammation, commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 1, 2.
Otitis Media with Effusion (OME)
- H65.90 - Unspecified nonsuppurative otitis media, unspecified ear 1
- H65.91 - Otitis media with effusion, right ear 1, 4
- H65.92 - Otitis media with effusion, left ear 1, 4
- H65.93 - Otitis media with effusion, bilateral 1, 4
OME is characterized by fluid in the middle ear without signs or symptoms of acute infection 1.
Chronic Otitis Media
- H65.20 - Chronic serous otitis media, unspecified ear 1
- H65.30 - Chronic mucoid otitis media, unspecified ear 1
- H66.10 - Chronic tubotympanic suppurative otitis media, unspecified ear 1
Chronic suppurative otitis media (CSOM) involves chronic inflammation with a non-intact tympanic membrane and persistent ear discharge 1, 5.
Recurrent Otitis Media
- H65.119 - Recurrent acute nonsuppurative otitis media 1
Recurrent AOM is defined as three or more episodes in 6 months or four or more episodes in 12 months with at least one in the past 6 months 1, 3.
Important Coding Considerations
Always specify laterality (right, left, bilateral, or unspecified) as this affects treatment decisions and surgical planning, particularly for tympanostomy tube placement 1.
Distinguish between acute and chronic presentations, as chronic OME is defined as persisting for 3 months or longer from diagnosis 1.
Document associated complications separately, such as:
- Conductive hearing loss (H90.0-H90.2) 1, 6
- Tympanic membrane perforation (H72.-) 1
- Mastoiditis (H70.-) 5
Common Pitfalls
The most frequent coding error is using unspecified codes when laterality and type are documented in the clinical note 1. The second most common mistake is failing to distinguish between AOM (acute infection with symptoms) and OME (fluid without acute infection), which have different treatment algorithms and prognoses 1, 2.