2025 ICD-10-CM code H95.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the ear and mastoid process - Intraoperative and postprocedural complications and disorders of ear and mastoid process, not elsewhere classified Diseases of the ear and mastoid process (H60-H95) Feed
Accidental puncture and laceration of the ear and mastoid process during a procedure.
Modifiers may be applicable depending on the circumstances and the specific procedure.Consult the AMA CPT manual or other applicable payer guidelines.
Medical necessity for coding H95.3 is established by the documentation that proves an accidental injury occurred during a necessary medical procedure. The injury should be directly attributable to the procedure.
The clinical responsibility for this code falls on the surgeon or physician performing the procedure during which the accidental injury occurred.Documentation must clearly show the causal link between the procedure and the injury. Post-operative care and treatment of the injury would also fall under the responsibility of the treating physician.
- Diseases of the ear and mastoid process (H60-H95)
- H95-H95.89: Intraoperative and postprocedural complications and disorders of ear and mastoid process, not elsewhere classified
In simple words: This code is for an accidental cut or puncture wound to the ear or the bone behind the ear (mastoid process) that happened during a medical operation or procedure.
This ICD-10-CM code classifies accidental puncture and laceration injuries to the ear and mastoid process that occur during a medical or surgical procedure.It specifically addresses unintended trauma inflicted on these structures in the context of a planned intervention. The injury may involve either the outer or middle ear, the mastoid bone, or a combination thereof.Accurate coding requires documentation specifying the accidental nature of the injury and its direct relationship to the procedure.
Example 1: During a tympanoplasty (ear surgery), the surgeon accidentally punctures the tympanic membrane while inserting instruments. This would be coded as H95.3., A patient undergoes mastoidectomy (removal of mastoid bone) and the surgeon accidentally lacerates the facial nerve during the procedure.H95.3 would be used to code the accidental laceration in addition to a code specifically describing the facial nerve injury., During a cochlear implant surgery, the surgeon accidentally punctures the inner ear during drilling. This would be coded as H95.3.Additional codes for complications of the cochlear implant would be necessary.
* Detailed operative report clearly indicating the accidental nature of the puncture or laceration.* Precise description of the location and extent of the injury.* Documentation linking the injury directly to the specific procedure performed.* Any subsequent treatments or interventions related to the injury.* Preoperative and postoperative assessments of the ear and mastoid.
** This code is specific to accidental injuries during procedures.Intentional injuries or injuries from other causes would require different codes.Always use the most specific code possible to accurately reflect the clinical findings.
- Payment Status: Active
- Modifier TC rule: The use of modifier TC (technical component) is not directly applicable to diagnosis codes like H95.3. Modifiers are generally applied to procedure codes.
- Specialties:Otolaryngology, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital