Tinnitus (ringing of the ears)
|Dx:||Tinnitus (ringing of the ears)|
|Pre-ICD10 counterpart:||none assigned|
|APACHE Como Component:||none|
|APACHE Acute Component:||none|
|External ICD10 Documentation|
- Tinnitus is the hearing of sound when no external sound is present. While often described as a ringing, it may also sound like a clicking, hiss or roaring. The sound may be soft or loud, low pitched or high pitched and appear to be coming from one ear or both. Most of the time, it comes on gradually. In some people, the sound causes depression or anxiety and can interfere with concentration.
Tinnitus is not a disease but a symptom that can result from a number of underlying causes. One of the most common causes is noise-induced hearing loss. Other causes include: ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, emotional stress, exposure to certain medications, a previous head injury, and earwax. It is more common in those with depression.
Symptom/Sign/Test Result not needed when cause known
- This code identifies a symptom or a sign, or an abnormal test result, not a disorder.
- So, you should code the cause of the symptom/sign/abnormal test, if known -- and if you do so, then also coding and combining the symptom/sign/abnormal test result to that cause is generally optional, but is guided by the following guidelines.
- Here are guidelines for whether or not to ALSO code the symptom/sign/abnormal test when you DO code the underlying cause:
- If it is a subjective symptom (e.g. pain) then coding it is optional
- When it is a physical exam finding (e.g. abdominal tenderness) then coding it is generally optional
- An exception is when the symptom/sign/abnormal testis so severe that all by itself it mandates hospitalization and/or a procedure -- a good example is a patient who has Wegener's granulomatosis is admitted due withHemoptysis. Since hemoptysis is a physical finding that fits this description of "severe" it should be coded, and combined with Wegener's.
- When it is an abnormal laboratory finding which in and of itself has relevance (e.g. hyperkalemia, hypoalbuminemia) then USUALLY code it
- You don't need to code the abnormal lab finding is when it is actually a major component of the underlying cause --- example is when a person presents with an acute MI, there is no need to code the abnormal troponin as Abnormal blood chemistry NOS
- The trickiest of these guidelines is for abnormal radiologic tests
- When the abnormal test is fully explained by the underlying diagnosis/diagnoses (e.g. pneumonia as cause of abnormal chest imaging, or a skull fracture with an intracranial hemorrhage both identified by an abnormal head CT) then coding the abnormal imaging result is optional
- But remember there are some rare things for which the abnormal imaging result IS part of coding the entity, for example we code retroperitoneal hemorrhage by the combination of Hemorrhage, NOS and Retroperitoneal area, diagnostic imaging, abnormal
- Sometimes there may be multiple symptom/sign/test result that might or might NOT be related to each other by virtue of having the same underlying cause. Since in the absence of KNOWING that cause, such assumptions may well be incorrect, do NOT combine them together if you are not certain they actually have the same underlying cause.
If this happens repeatedly during the same ward or unit stay, only code it the first time it happens, rather than each time it happens. See ICD10 codes only coded the first time for other diagnoses coded this way.
Alternate ICD10s to consider coding instead or in addition
- Hearing loss, any type
- Disorder of middle ear, NOS
- Otitis externa, infectious
- Perforation of tympanic membrane (eardrum)
- Otitis media, infectious
- Otitis media, noninfectious
- Effusion of the ear
- Meniere's disease
- Depression (major depressive disorder, recurrent depression)
- Depressive episode without major depressive disorder
- Post-concussion syndrome
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (SMW)