Otitis Media ICD-10-CM codes

Otitis media documented without further detail is H66.9- (otitis media, unspecified): H66.90 unspecified ear, H66.91 right, H66.92 left, H66.93 bilateral. Acute otitis media without a stated type indexes to H66.90 as well, so the type (suppurative or serous) is worth capturing when documented.

Acute suppurative (purulent) otitis media is H66.0-, split by whether the eardrum has ruptured: H66.00- without rupture and H66.01- with spontaneous rupture. The sixth character carries both laterality and recurrence: 1 right, 2 left, 3 bilateral, 9 unspecified, and 4 through 7 for recurrent right, left, bilateral, and unspecified ear. The H66.01- codes already describe the spontaneous rupture. Category H65, by contrast, carries a use additional code note for any associated perforated tympanic membrane (H72.-), so a perforation with nonsuppurative otitis media is coded separately.

Nonsuppurative otitis media (fluid without pus) is category H65: acute serous H65.0- (H65.03 bilateral, H65.04 to H65.07 recurrent), chronic serous H65.2-, chronic mucoid H65.3-, and unspecified nonsuppurative H65.9-. Otitis media with effusion and glue ear index to H65. Chronic suppurative otitis media is H66.1- through H66.3-.

Both H65 and H66 carry a use additional code instruction for tobacco exposure: Z77.22 for environmental tobacco smoke, P96.81 for the perinatal period, F17.- for current nicotine dependence, Z87.891 for history, or Z72.0 for tobacco use. Myringotomy tube status is Z96.22 and a persistent perforation after the infection resolves is H72.-.