ICD-10 Coding for Acute Otitis Media(H66.0-, H65.0-)
Complete ICD-10-CM coding and documentation guide for Acute Otitis Media. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Otitis Media
H65-H67Primary Range
Diseases of middle ear and mastoid
This range includes all types of otitis media, including acute, chronic, and suppurative forms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| H66.0- | Acute suppurative otitis media | Use when documentation specifies acute suppurative otitis media with or without perforation. |
|
| H65.0- | Acute serous otitis media | Use when documentation specifies serous effusion without purulence. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute otitis media
Essential facts and insights about Acute Otitis Media
Primary ICD-10-CM Codes for acute otitis media
Decision Criteria
clinical Criteria
- Presence of purulent effusion and bulging tympanic membrane.
documentation Criteria
- Documentation must specify laterality and type of otitis media.
Applicable To
- Acute purulent otitis media
- Acute otitis media with perforation
Excludes
- Chronic suppurative otitis media (H66.3-)
Clinical Validation Requirements
- Bulging tympanic membrane
- Purulent effusion
- Possible tympanic membrane perforation
Code-Specific Risks
- Risk of using unspecified codes if laterality is not documented.
Coding Notes
- Ensure documentation specifies laterality and type of effusion.
H65.0- - Acute serous otitis media
Use when documentation specifies serous effusion without purulence.
Applicable To
- Acute nonsuppurative otitis media
Excludes
- Chronic serous otitis media (H65.2-)
Clinical Validation Requirements
- Middle ear effusion without pus
- Clear or serous fluid
Coding Notes
Ensure documentation specifies the type of effusion.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Exposure to environmental tobacco smoke
Z77.22Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Otitis Media to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code H66.0-.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Increases risk of audit., Financial: Potential for denied claims.
Mitigation Strategy
Use templates that prompt for effusion type., Educate clinicians on documentation requirements.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Query for laterality and type of otitis media to use specific codes.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation supports the most specific code possible.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acute Otitis Media, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Otitis Media
Use these documentation templates to ensure complete and accurate documentation for Acute Otitis Media. These templates include all required elements for proper coding and billing.
Pediatric acute otitis media
Specialty: PediatricsRequired Elements
- History of present illness
- Physical examination findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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