ICD-10-CM Code H61.20

Valid for Submission

H61.20 is a billable code used to specify a medical diagnosis of impacted cerumen, unspecified ear. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code H61.20 might also be used to specify conditions or terms like c/o - wax in ear, ear symptom, excessive cerumen in ear canal, impacted cerumen, o/e - wax in auditory canal, wax in ear canal, etc

The code H61.20 is not usually sufficient justification for admission to an acute care hospital when used as a principal diagnosis.

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code H61.20 are found in the index:

• - Ear - See Also: condition;
  • - wax (impacted) - H61.20

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

• Questionable admission codes - Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• C/O - wax in ear
• Ear symptom
• Excessive cerumen in ear canal
• Impacted cerumen
• O/E - wax in auditory canal
• Wax in ear canal

Diagnostic Related Groups

The ICD-10 code H61.20 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2020.

• 154 - OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC
• 155 - OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC
• 156 - OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Convert H61.20 to ICD-9

• 380.4 - Impacted cerumen (Approximate Flag)

Code Classification

• Diseases of the ear and mastoid process (H60–H95)
  • Diseases of external ear (H60-H62)
    • Other disorders of external ear (H61)

Code History

• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
  (First year ICD-10-CM implemented into the HIPAA code set)
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Tools

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• Convert H61.20 to ICD-9