ICD-10 Code H61.21

Impacted cerumen, right ear

Version 2019 Billable Code Questionable Admission Codes

Valid for Submission

H61.21 is a billable code used to specify a medical diagnosis of impacted cerumen, right ear. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

ICD-10: H61.21
Short Description:Impacted cerumen, right ear
Long Description:Impacted cerumen, right ear

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 mandated 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

Information for Medical Professionals

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.

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). The diagnosis code H61.21 is grouped in the following groups for version MS-DRG V37.0 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 H61.21 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 380.4 - Impacted cerumen (Approximate Flag)

Synonyms

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

  • Excessive cerumen in ear canal
  • Impacted cerumen
  • Impacted cerumen in right ear
  • Wax in ear canal

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 H61.21 are found in the index:


Information for Patients


Ear Disorders

Your ear has three main parts: outer, middle and inner. You use all of them in hearing. Sound waves come in through your outer ear. They reach your middle ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, in your middle ear. The vibrations travel to your inner ear, a snail-shaped organ. The inner ear makes the nerve impulses that are sent to the brain. Your brain recognizes them as sounds. The inner ear also controls balance.

A variety of conditions may affect your hearing or balance:

  • Ear infections are the most common illness in infants and young children.
  • Tinnitus, a roaring in your ears, can be the result of loud noises, medicines or a variety of other causes.
  • Meniere's disease may be the result of fluid problems in your inner ear; its symptoms include tinnitus and dizziness.
  • Ear barotrauma is an injury to your ear because of changes in barometric (air) or water pressure.

Some ear disorders can result in hearing disorders and deafness.


[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.