Version 2024

2024 ICD-10-CM Diagnosis Code H90.A11

Conductive hearing loss, unilateral, right ear with restricted hearing on the contralateral side

ICD-10-CM Code:: H90.A11
ICD-10 Code for:: Condctv hear loss, uni, r ear with rstrcd hear cntra side
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Chronic
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Code Information
Clinical Classification
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Replacement Code
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the ear and mastoid process
(H60–H95)
- Other disorders of ear
  (H90-H94)
  - Conductive and sensorineural hearing loss
    (H90)

H90.A11 is a billable diagnosis code used to specify a medical diagnosis of conductive hearing loss, unilateral, right ear with restricted hearing on the contralateral side. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Clinical Classification

Clinical Category is Hearing loss
CCSR Category Code: EAR004
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

H90.A11 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
154	OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC	03	1.5382
155	OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC	03	0.9466
156	OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC	03	0.6555

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

H90A11 replaces the following previously assigned ICD-10-CM code(s):

H90.2 - Conductive hearing loss, unspecified

Convert H90.A11 to ICD-9-CM

ICD-9-CM Code: 389.05 - Condctv hear loss,unilat
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
The condition places limitations on self-care, independent living, and social interactions.