Definition: Otitis media is an inflammation of the middle ear. Otitis media with effusion (OME) refers to fluid in the middle ear space but without the symptoms of an acute infection. Therefore you know to look up "otitis media" in ICD-9's Alphabetic Index. When you locate "otitis" you find among the entries one of the above synonyms "serous":
serous 381.4
acute or subacute 381.01
chronic (simple) 381.10.
The listing points you to nonspecified otitis media code 381.4 (Nonsuppurative otitis media not specified as acute or chronic) which includes "otitis media: serous" and "otitis media: with effusion." If you have further information as to whether the patient has acute or chronic OM you can use the specific diagnosis of 381.01 or 381.10.
Alternative: If a medical dictionary doesn't give you the information you need to locate an appropriate listed synonym go back to the otolaryngologist for more information. "I ask the physician to explain the unknown term to me so that we can get the right code " Austin says.
Slanted Brackets Signal Duel Coding
ICD-9's Alphabetic Index sometimes includes additional coding directives. For instance if you find slanted brackets following a code you must use these codes together Bishop says. "You should look up the bracketed code to make sure the entry applies " he says.
Case: After determining that "fungal otitis externa" refers to "otomycosis " you locate the latter phrase in the Alphabetic……….
For more read:-
http://www.supercoder.com/articles/articles-alerts/otc/6-guidelines-point-you-to-the-correct-complicated-ear-diagnoses/
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