2025 ICD-10-CM code H61.1
(Active) Effective Date: N/A Diseases of the ear and mastoid process - Diseases of external ear VIII Diseases of the ear and mastoid process Feed
Noninfective disorders of the pinna (outer ear).
Laterality modifiers may apply for specifying the affected ear (right, left, or bilateral).
Medical necessity must be established by demonstrating the impact of the condition on the patient's auditory function, overall health, or quality of life.This might include pain, discomfort, cosmetic concerns, or functional limitations. Documentation should support the chosen treatment plan.
Diagnosis and management of this condition fall under the purview of otolaryngologists or general practitioners. Clinical responsibility includes accurate assessment, diagnosis, and appropriate treatment or referral.
In simple words: This code refers to problems with the outer part of the ear that aren't caused by infections, like a deformed or injured ear.
This code encompasses acquired deformities and other noninfective conditions affecting the pinna, such as hematoma.It excludes conditions like cauliflower ear (M95.1) and gouty tophi of the ear (M1A.-).
Example 1: A patient presents with an acquired deformity of the pinna following an injury., A patient develops a hematoma of the pinna after blunt trauma., A patient has a congenital malformation of the pinna, which is considered a non-infectious disorder.
Documentation should clearly specify the nature of the noninfective disorder, its etiology (if known), laterality (right, left, or bilateral), and any associated symptoms or functional impairments. Any history of trauma or prior ear conditions should also be documented.
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- Payment Status: Active
- Specialties:Otolaryngology, General Practice
- Place of Service:Office, Outpatient Hospital, Emergency Room - Hospital, Independent Clinic, Federally Qualified Health Center