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H66.90
ICD-10-CM
Acute Otitis Media

Learn about Acute Otitis Media (AOM), also known as middle ear infection, diagnosis. This resource provides information on AOM clinical documentation, medical coding, and healthcare best practices for accurate diagnosis and treatment. Find details on otitis media symptoms, causes, and treatment options. Improve your understanding of AOM for effective patient care and accurate medical records.

Also known as

AOM
Middle Ear Infection

Diagnosis Snapshot

Key Facts
  • Definition : Infection of the middle ear, often bacterial or viral.
  • Clinical Signs : Ear pain, fever, hearing loss, irritability, tugging at the ear.
  • Common Settings : Pediatric clinics, urgent care, family practice.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC H66.90 Coding
H65-H66

Diseases of middle ear and mastoid

Includes various middle ear infections like acute otitis media.

H60-H95

Diseases of the ear and mastoid process

Encompasses all ear and mastoid disorders, including otitis media.

J00-J99

Diseases of the respiratory system

Includes respiratory infections that can sometimes lead to otitis media.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the otitis media acute?

  • Yes

    Is it bilateral?

  • No

    Do NOT code as acute otitis media. Consider other otitis media codes (e.g., chronic).

Code Comparison

Related Codes Comparison

When to use each related code

Description
Middle ear infection, often bacterial or viral.
Fluid buildup in middle ear, no infection.
Inflammation of outer ear canal, swimmers ear.

Documentation Best Practices

Documentation Checklist
  • Document laterality (left, right, bilateral).
  • Describe otoscopic findings (e.g., bulging TM, erythema).
  • Note symptoms (e.g., otalgia, fever, hearing loss).
  • Document symptom duration and onset.
  • If recurrent, specify frequency and previous treatments.

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Missing or incorrect laterality (right, left, bilateral) for AOM can lead to claim denials and inaccurate data reporting.

  • Otitis Media Type

    Unspecified otitis media may trigger audits. Accurate coding requires specifying acute, with/without effusion (OME), etc.

  • Causative Organism

    If AOM is bacterial, documenting and coding the causative organism when known improves clinical data specificity.

Mitigation Tips

Best Practices
  • Timely diagnosis: Otoscopy for AOM (ICD-10 H66.90).
  • Document AOM symptoms: Earache, fever (ICD-10 R52.9). CDI best practice.
  • Antibiotic stewardship: Judicious use for AOM. Healthcare compliance.
  • Pain management: Analgesics for AOM ear pain. Coding accuracy (ICD-10 H66.90).
  • Follow-up care crucial: Monitor AOM resolution. Improve documentation.

Clinical Decision Support

Checklist
  • Verify ear pain, bulging TM, or otorrhea (ICD-10 H66.90).
  • Document symptom duration for accurate AOM coding.
  • Assess fever, irritability for severity & management.
  • Consider antibiotic guidelines, shared decision-making.
  • Check for pneumatic otoscopy documentation for AOM diagnosis.

Reimbursement and Quality Metrics

Impact Summary
  • Acute Otitis Media (AOM) reimbursement hinges on accurate ICD-10-CM coding (H66.90, H66.0-, H66.1-) and timely filing.
  • AOM coding errors impact hospital revenue cycle, increasing claim denials and reducing overall reimbursement.
  • Quality metrics for AOM focus on antibiotic prescribing practices and pain management, affecting hospital performance scores.
  • Proper AOM documentation and coding are crucial for accurate hospital reporting and public health surveillance data.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective antibiotic treatment strategies for acute otitis media (AOM) in pediatric patients with penicillin allergies?

A: Managing acute otitis media (AOM) in children with penicillin allergies requires careful antibiotic selection. For non-type-1 hypersensitivity reactions, cephalosporins like cefdinir or cefpodoxime are often suitable alternatives. However, in cases of type-1 penicillin allergy (e.g., anaphylaxis, angioedema), macrolides such as azithromycin or clarithromycin may be considered. It's crucial to consider local resistance patterns when selecting antibiotics. For severe cases or treatment failure, consultation with an infectious disease specialist or allergist is recommended. Explore how our AOM management protocols address antibiotic stewardship and allergy considerations.

Q: How can I differentiate acute otitis media (AOM) from otitis media with effusion (OME) in a clinical setting, and what are the implications for treatment decisions?

A: Distinguishing AOM from OME relies on identifying signs and symptoms of acute infection. AOM typically presents with rapid onset of ear pain, bulging tympanic membrane, and often fever, while OME shows a middle ear effusion without acute inflammatory signs. Otoscopic examination revealing a cloudy, bulging eardrum with reduced mobility suggests AOM. OME, on the other hand, presents with a retracted or neutral eardrum, often with a visible effusion. Treatment for AOM often involves antibiotics, while OME management focuses on observation and addressing underlying causes if necessary. Misdiagnosis can lead to unnecessary antibiotic use or delayed AOM treatment. Consider implementing standardized otoscopy techniques for accurate AOM diagnosis and explore our guidelines on evidence-based OME management.

Quick Tips

Practical Coding Tips
  • Code H66.90 for unspecified AOM
  • Document laterality for AOM coding
  • Use ICD-10-CM for AOM diagnosis
  • Check for effusion, code separately
  • Consider age-specific AOM codes

Documentation Templates

Patient presents with symptoms consistent with acute otitis media (AOM), also known as a middle ear infection.  The patient reports ear pain (otalgia), specifically mentioning a sharp, throbbing pain in the affected ear.  Onset of symptoms began approximately two days ago and has progressively worsened.  Associated symptoms include fever of 101.5 degrees Fahrenheit, irritability, difficulty sleeping, and decreased appetite.  Otoscopic examination reveals a bulging tympanic membrane with erythema and reduced mobility.  Conductive hearing loss is noted in the affected ear.  Diagnosis of acute otitis media is confirmed based on clinical presentation and otoscopic findings.  Differential diagnoses considered include otitis externa, eustachian tube dysfunction, and upper respiratory infection.  Treatment plan includes a prescription for amoxicillin, an antibiotic commonly used for ear infections, to address the bacterial infection.  Patient education provided on pain management strategies, such as over-the-counter analgesics like ibuprofen or acetaminophen, and the importance of completing the full course of antibiotics.  Follow-up appointment scheduled in one week to assess treatment response and resolution of symptoms.  Medical billing codes will include those specific to acute otitis media diagnosis and antibiotic prescription.  Patient advised to return if symptoms worsen or do not improve within 48-72 hours.