Ear, Nose and Throat Superbill Template Date of service: Insurance:
Patient name:
Subscriber name:
Address: Group #: Previous balance:
Copay: Today’s charges:
Phone: Account #: Today’s payment: check#
DOB: Age: Sex: Physician name: Balance due:
MOD. Patient E/M New Est MOD. I&D, intraoral, tongue, floor of
mouth, sublingual, superficial
41005 MOD. Flexible laryngoscopy with
removal of lesion 31578
Level I 99201 99211 I&D, intraoral, tongue, floor of
mouth, sublingual, superficial
41005 Flexible laryngoscopy with
stroboscopy 31579
Level II 99202 99212 I&D, extraoral, floor of mouth,
sublingual 41015 Incision of labial frenulum 40806
Level III 99203 99213 I&D, extraoral, floor of mouth,
submental 41016 Excision lingual frenulum 41115
Level IV 99204 99214 I&D, extraoral, submandibular 41017 Uvulectomy 42140
Level V 99205 99215 I&D, peritonsillar 42700 Destruction of lesion, palate or
uvula (thermal, cryo) 42160
Consultations I&D infected thyroglossal duct
cyst 60000 Palate Somnoplasty 42145-
52
Consultation Level I 99241 I&D external ear, simple 69000 Turbinate Somnoplasty 30140-
52
Consultation Level II 99242 I&D external ear, complicated 69005 Cautery ablation, any method,
superficial 30801
Consultation Level III 99243 I&D, external auditory canal 69020 Cautery ablation, intramural 30802
Consultation Level IV 99244 Ear Procedures Removal of foreign body,
intranasal 30300
Consultation Level V 99245 Myringotomy 69420 Removal of foreign body, external
auditory canal 69200
Biopsy Tympanostomy 69433 Vestibular Function Tests
Biopsy (Skin) 11100 Tympanostomy with general
anesthesia 69436 Spontaneous nystagmus 92531
each additional skin biopsy 11001 Impacted cerumen removal 69210 Caloric vestibular test 92532
Biopsy, nasal 30100 Control of Nasal Bleed Optokinetic nystagmus test 92534
Biopsy, lip 40490 Simple nasal hemorrhage
control 30901 Basic vestibular evaluation, with
recording 92540
Biopsy, vestibule of mouth 40808 Anterior, complete nasal 30903 Spontaneous nystagmus, with 92541
hemorrhage control recording
Biopsy, tongue (anterior 2/3) 41100 Posterior nasal hemorrhage
control 30905 Positional nystagmus test, with
recording 92542
Biopsy, tongue (posterior
1/3) 41105 Nasal Endoscopy Caloric vestibular test, with
recording 92543
Biopsy, floor of mouth 41108 Diagnostic nasal endoscopy 31231 Optokinetic nystagmus test, with
recording 92544
Biopsy, palate, uvula 42100 Maxillary sinusoscopy 31232 Oscillating tracking test, with
recording 92545
Biopsy, oropharynx 42800 Sphenoid sinusoscopy 31235 Tympanometry and reflex
threshold measurements 92550
Biopsy, hypopharynx 42802 Nasal endoscopic biopsy,
polypectomy or debridement 31237 Pure tone screening 92551
Biopsy, nasopharynx, visible
lesion 42804 Nasal endoscopic hemorrhage
control 31238 Pure tone audiometry; air only 92552
Biopsy, nasopharynx,
unknown primary 42806 Nasal endoscopy with
dacryocystorhinostomy 31239 Pure tone audiometry: air and
bone 92553
Sialolithotomy Nasal endoscopy with concha
bullosa resection 31240 Speech audiometry threshold 92555
Sialolithotomy,
uncomplicated, intraoral 42330 Endoscopic partial
ethmoidectomy 31254 Speech audiometry threshold with
speech recognition 92556
Sialolithotomy,
submandibular, complicated,
intraoral
42335 Endoscopic total
ethmoidectomy 31255 Comprehensive audiometry 92557
Sialolithotomy, parotid,
extraoral or complicated
intraoral
42340 Endoscopic maxillary
antrostomy 31256 Percutaneous allergy skin test 95004
Incision and Drainage Endoscopic maxillary tissue
removal 31267 Allergy testing for venoms 95017
I&D abscess, simple, single 10060 Frontal sinus endoscopy 31276 Allergy testing for drugs, biological 95018
I&D, complicated, multiple 10061 Endoscopic sphenoidotomy 31287 Intradermal allergy tests 95024
I&D hematoma, seroma, fluid
collection 10140 Endoscopic removal of
sphenoid tissue 31288 Single allergy injection (including
extract) 95120
Puncture aspiration of
abscess, cyst, hematoma 10160 Endoscopic maxillary sinus
dilation 31295 Two or more allergy injections
(including extract) 95125
I&D complex, postoperative
wound infection 10180 Endoscopic frontal sinus
dilation 31296 Preparation and provision of
antigens 95165
I&D nasal abscess or
hematoma 30000 Endoscopic sphenoid sinus
dilation 31297 Inhalation bronchial challenge 95070
I&D nasal septum abscess or
hematoma 30020 Flexible Laryngoscopy Nasopharyngoscopy 92511
I&D vestibule of mouth,
simple 40800 Flexible diagnostic
laryngoscopy 31575 Single allergy injection (without
extract provision) 95115
I&D vestibule of mouth,
complicated 40801 Flexible laryngoscopy with
biopsy 31576 Venipuncture 36415
I&D, intraoral, tongue, floor of
mouth, lingual 41000 Flexible laryngoscopy with
foreign body removal 31577 Handling 99000
ICD-10 Codes Diagnosis
C00.9 Malignant neoplasm of lip, unspecified
C01 Malignant neoplasm of base of tongue
C02.3 Malignant neoplasm of anterior two-thirds of tongue, part unspecified
C04.9 Malignant neoplasm of floor of mouth, unspecified
C05.0 Malignant neoplasm of hard palate
C06.9 Malignant neoplasm of mouth, unspecified
C07 Malignant neoplasm of parotid gland
C08.0 Malignant neoplasm of submandibular gland
C10.9 Malignant neoplasm of oropharynx, unspecified
C11.9 Malignant neoplasm of nasopharynx, unspecified
C13.9 Malignant neoplasm of hypopharynx, unspecified
C30.0 Malignant neoplasm of nasal cavity
C32.0 Malignant neoplasm of glottis
C32.1 Malignant neoplasm of supraglottis
C32.9 Malignant neoplasm of larynx, unspecified
C44.00 Unspecified malignant neoplasm of skin of lip
C44.01 Basal cell carcinoma of skin of lip
C44.02 Squamous cell carcinoma of skin of lip
C44.09 Other specified malignant neoplasm of skin of lip
C44.202 Unspecified malignant neoplasm of skin of right ear and external auricular canal
C44.209 Unspecified malignant neoplasm of skin of left ear and external auricular canal
C44.212 Basal cell carcinoma of skin of right ear and external auricular canal
C44.219 Basal cell carcinoma of skin of left ear and external auricular canal
C44.222 Squamous cell carcinoma of skin of right ear and external auricular canal
C44.229 Squamous cell carcinoma of skin of left ear and external auricular canal
C44.301 Unspecified malignant neoplasm of skin of nose
C44.309 Unspecified malignant neoplasm of other parts of face
C44.311 Basal cell carcinoma of skin of nose
C44.319 Basal cell carcinoma of skin of other parts of face
C44.321 Squamous cell carcinoma of skin of nose
C44.329 Squamous cell carcinoma of skin of other parts of face
C44.40 Unspecified malignant neoplasm of skin of scalp and neck
C44.41 Basal cell carcinoma of skin of scalp and neck
C44.42 Squamous cell carcinoma of skin of scalp and neck
C44.49 Other specified malignant neoplasm of skin of scalp and neck
C73 Malignant neoplasm of thyroid gland
C77.0 Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck
D00.01 Carcinoma in situ of labial mucosa and vermilion border
D00.02 Carcinoma in situ of buccal mucosa
D00.03 Carcinoma in situ of gingiva and edentulous alveolar ridge
D00.04 Carcinoma in situ of soft palate
D00.05 Carcinoma in situ of hard palate
D00.06 Carcinoma in situ of floor of mouth
D00.07 Carcinoma in situ of tongue
D00.08 Carcinoma in situ of pharynx
D10.30 Benign neoplasm of unspecified part of mouth
D10.39 Benign neoplasm of other parts of mouth
D11.0 Benign neoplasm of parotid gland
D11.7 Benign neoplasm of other major salivary gland
D14.0 Benign neoplasm of middle ear, nasal cavity and accessory sinuses
D14.1 Benign neoplasm of larynx
D22.11 Melanocytic nevi of right eyelid, including canthus
D22.12 Melanocytic nevi of left eyelid, including canthus
D23.11 Other benign neoplasm of skin of right eyelid, including canthus
D23.12 Other benign neoplasm of skin of left eyelid, including canthus
D33.3 Benign neoplasm of cranial nerves
D35.2 Benign neoplasm of pituitary gland
D37.01 Neoplasm of uncertain behavior of lip
D37.02 Neoplasm of uncertain behavior of tongue
D37.030 Neoplasm of uncertain behavior of the parotid salivary glands
D37.031 Neoplasm of uncertain behavior of the sublingual salivary glands
D37.032 Neoplasm of uncertain behavior of the submandibular salivary glands
D37.04 Neoplasm of uncertain behavior of the minor salivary glands
D37.05 Neoplasm of uncertain behavior of pharynx
D37.09 Neoplasm of uncertain behavior of other specified sites of the oral cavity
D38.0 Neoplasm of uncertain behavior of larynx
D48.5 Neoplasm of uncertain behavior of skin
D49.0 Neoplasm of unspecified behavior of digestive system
D49.1 Neoplasm of uncertain behavior of respiratory system
D49.2 Neoplasm of uncertain behavior of bone, soft tissue, and skin
D49.7 Neoplasm of uncertain behavior of endocrine glands and other parts of nervous system
E04.1 Nontoxic single thyroid nodule
E04.2 Nontoxic multinodular goiter
E05.90 Thyrotoxicosis, unspecified without thyrotoxic crisis or storm
E06.9 Thyroiditis, unspecified
E21.0 Primary hyperparathyroidism
E21.1 Secondary hyperparathyroidism, not elsewhere classified
E21.2 Other hyperparathyroidism
E84.9 Cystic fibrosis
F45.8 Other somatoform disorders
F80.4 Speech and language development delay due to hearing loss
G47.09 Other insomnia
G47.19 Other hypersomnia
G47.30 Sleep apnea, unspecified
G47.33 Obstructive sleep apnea (adult) (pediatric)
G50.1 Atypical facial pain
G51.0 Bell’s palsy
H6.301 Acquired stenosis of right external ear canal, unspecified
H60.331 Swimmer’s ear, right ear
H60.332 Swimmer’s ear, left ear
H60.333 Swimmer’s ear, bilateral
H60.391 Other infective otitis externa, right ear
H60.392 Other infective otitis externa, left ear
H60.393 Other infective otitis externa, bilateral
H60.511 Acute actinic otitis externa, right ear
H60.512 Acute actinic otitis externa, left ear
H60.513 Acute actinic otitis externa, bilateral
H60.521 Acute chemical otitis externa, right ear
H60.522 Acute chemical otitis externa, left ear
H60.523 Acute chemical otitis externa, bilateral
H60.531 Acute contact otitis externa, right ear
H60.532 Acute contact otitis externa, left ear
H60.533 Acute contact otitis externa, bilateral
H60.541 Acute eczematoid otitis externa, right ear
H60.542 Acute eczematoid otitis externa, left ear
H60.543 Acute eczematoid otitis externa, bilateral
H60.551 Acute reactive otitis externa, right ear
H60.552 Acute reactive otitis externa, left ear
H60.553 Acute reactive otitis externa, bilateral
H60.591 Other noninfective acute otitis externa, right ear
H60.592 Other noninfective acute otitis externa, left ear
H60.593 Other noninfective acute otitis externa, bilateral
H60.61 Unspecified chronic otitis externa, right ear
H60.62 Unspecified chronic otitis externa, left ear
H60.63 Unspecified chronic otitis externa, bilateral
H61.011 Acute perichondritis of right external ear
H61.012 Acute perichondritis of left external ear
H61.013 Acute perichondritis of external ear, bilateral
H61.021 Chronic perichondritis of right external ear
H61.022 Chronic perichondritis of left external ear
H61.023 Chronic perichondritis of external ear, bilateral
H61.121 Hematoma of pinna, right ear
H61.122 Hematoma of pinna, left ear
H61.123 Hematoma of pinna, bilateral
H61.21 Impacted cerumen, right ear
H61.22 Impacted cerumen, left ear
H61.23 Impacted cerumen, bilateral
H61.302 Acquired stenosis of left external ear canal, unspecified
H61.303 Acquired stenosis of external ear canal, unspecified, bilateral
H61.391 Other acquired stenosis of right external ear canal
H61.392 Other acquired stenosis of left external ear canal
H61.393 Other acquired stenosis of external ear canal, bilateral
H61.811 Exostosis of right external ear canal
H61.812 Exostosis of left external ear canal
H61.813 Exostosis of external ear canal, bilateral
H65.01 Acute serous otitis media, right ear
H65.02 Acute serous otitis media, left ear
H65.03 Acute serous otitis media, bilateral
H65.04 Acute serous otitis media, recurrent, right ear
H65.05 Acute serous otitis media, recurrent, left ear
H65.06 Acute serous otitis media, recurrent, bilateral
H65.91 Unspecified nonsuppurative otitis media, right ear
H65.92 Unspecified nonsuppurative otitis media, left ear
H65.93 Unspecified nonsuppurative otitis media, bilateral
H66.001 Acute suppurative otitis media without spontaneous rupture of ear drum, right ear
H66.002 Acute suppurative otitis media without spontaneous rupture of ear drum, left ear
H66.003 Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral
H66.004 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, right ear
H66.005 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear
H66.006 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral
H66.011 Acute suppurative otitis media with spontaneous rupture of ear drum, right ear
H66.012 Acute suppurative otitis media with spontaneous rupture or ear drum, left ear
H66.013 Acute suppurative otitis media with spontaneous rupture of ear drum, bilateral
H66.014 Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, right ear
H66.015 Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, left ear
H66.016 Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, bilateral
H66.11 Chronic tubotympanic suppurative otitis media, right ear
H66.12 Chronic tubotympanic suppurative otitis media, left ear
H66.13 Chronic tubotympanic suppurative otitis media, bilateral
H66.21 Chronic atticoantral suppurative otitis media, right ear
H66.22 Chronic atticoantral suppurative otitis media, left ear
H66.23 Chronic atticoantral suppurative otitis media, bilateral
H66.3X1 Other chronic suppurative otitis media, right ear
H66.3X2 Other chronic suppurative otitis media, left ear
H66.3X3 Other chronic suppurative otitis media, bilateral
H66.91 Otitis media, unspecified, right ear
H66.92 Otitis media, unspecified, left ear
H66.93 Otitis media, unspecified, bilateral
H69.81 Other specified disorder of Eustachian tube, right ear
H69.82 Other specified disorder of Eustachian tube, left ear
H69.83 Other specified disorder of Eustachian tube, bilateral
H70.11 Chronic mastoiditis, right ear
H70.12 Chronic mastoiditis, left ear
H70.13 Chronic mastoiditis, bilateral
H71.01 Cholesteatoma of attic, right ear
H71.02 Cholesteatoma of attic, left ear
H71.03 Cholesteatoma of attic, bilateral
H71.11 Cholesteatoma of tympanum, right ear
H71.12 Cholesteatoma of tympanum, left ear
H71.13 Cholesteatoma of tympanum, bilateral
H71.21 Cholesteatoma of mastoid, right ear
H71.22 Cholesteatoma of mastoid, left ear
H71.23 Cholesteatoma of mastoid, bilateral
H71.91 Unspecified cholesteatoma, right ear
H71.92 Unspecified cholesteatoma, left ear
H71.93 Unspecified cholesteatoma, bilateral
H72.01 Central perforation of tympanic membrane, right ear
H72.01 Central perforation of tympanic membrane, right ear
H72.02 Central perforation of tympanic membrane, left ear
H72.02 Central perforation of tympanic membrane, left ear
H72.03 Central perforation of tympanic membrane, bilateral
H72.03 Central perforation of tympanic membrane, bilateral
H72.11 Attic perforation of tympanic membrane, right ear
H72.12 Attic perforation of tympanic membrane, left ear
H72.13 Attic perforation of tympanic membrane, bilateral
H72.2X1 Other marginal perforations of tympanic membrane, right ear
H72.2X2 Other marginal perforations of tympanic membrane, left ear
H72.2X3 Other marginal perorations of tympanic membrane, bilateral
H72.811 Multiple perforations of tympanic membrane, right ear
H72.812 Multiple perforations of tympanic membrane, left ear
H72.813 Multiple perforations of tympanic membrane, bilateral
H72.91 Unspecified perforation of tympanic membrane, right ear
H72.92 Unspecified perforation of tympanic membrane, left ear
H72.93 Unspecified perforation of tympanic membrane, bilateral
H73.11 Chronic myringitis, right ear
H73.12 Chronic myringitis, left ear
H73.13 Chronic myringitis, bilateral
H74.11 Adhesive right middle ear disease
H74.12 Adhesive left middle ear disease
H74.13 Adhesive middle ear disease, bilateral
H80.91 Unspecified otosclerosis, right ear
H80.92 Unspecified otosclerosis, left ear
H80.93 Unspecified otosclerosis, bilateral
H81.01 Meniere’s disease, right ear
H81.02 Meniere’s disease, left ear
H81.03 Meniere’s disease, bilateral
H81.11 Benign paroxysmal vertigo, right ear
H81.12 Benign paroxysmal vertigo, left ear
H81.13 Benign paroxysmal vertigo, bilateral
H81.41 Vertigo of central origin, right ear
H81.42 Vertigo of central origin, left ear
H81.43 Vertigo of central origin, bilateral
H83.2X1 Labyrinthine dysfunction, right ear
H83.2X2 Labyrinthine dysfunction, left ear
H83.2X3 Labyrinthine dysfunction, bilateral
H83.3X1 Noise effects on right inner ear
H83.3X2 Noise effect on left inner ear
H83.3X3 Noise effects on inner ear, bilateral
H90.0 Conductive hearing loss, bilateral
H90.11 Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.12 Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.2 Conductive hearing loss, unspecified
H90.3 Sensorineural hearing loss, bilateral
H90.41 Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.42 Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.5 Unspecified sensorineural hearing loss
H90.6 Mixed conductive and sensorineural hearing loss, bilateral
H90.71 Mixed conductive and sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
H90.72 Mixed conductive and sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.8 Mixed conductive and sensorineural hearing loss, unspecified
H91.11 Presbycusis, right ear
H91.12 Presbycusis, left ear
H91.13 Presbycusis, bilateral
H91.91 Unspecified hearing loss, right ear
H91.92 Unspecified hearing loss, left ear
H91.93 Unspecified hearing loss, bilateral
H92.01 Otalgia, right ear
H92.02 Otalgia, left ear
H92.03 Otalgia, bilateral
H93.11 Tinnitus, right ear
H93.12 Tinnitus, left ear
H93.13 Tinnitus, bilateral
H93.291 Other abnormal auditory perceptions, right ear
H93.292 Other abnormal auditory perceptions, left ear
H93.293 Other abnormal auditory perceptions, bilateral
J01.80 Other acute sinusitis
J01.81 Other acute recurrent sinusitis
J01.90 Acute sinusitis, unspecified
J01.91 Acute recurrent sinusitis, unspecified
J02.8 Acute pharyngitis due to other specified organism
J02.9 Acute pharyngitis, unspecified
J04.0 Acute laryngitis
J30.0 Vasomotor rhinitis
J30.1 Allergic rhinitis due to pollen
J30.2 Other seasonal allergic rhinitis
J30.89 Other allergic rhinitis
J30.9 Allergic rhinitis, unspecified
J31.0 Chronic rhinitis
J31.2 Chronic pharyngitis
J32.0 Chronic maxillary sinusitis
J32.1 Chronic frontal sinusitis
J32.2 Chronic ethmoidal sinusitis
J32.3 Chronic sphenoidal sinusitis
J32.4 Chronic pansinusitis
J32.8 Other chronic sinusitis
J33.0 Polyp of nasal cavity
J33.1 Polypoid sinus degeneration
J33.8 Other poly of sinus
J34.2 Deviated nasal septum
J34.3 Hypertrophy of nasal turbinates
J34.81 Nasal mucositis (ulcerative)
J34.89 Other specified disorder of nose and nasal sinuses
J35.01 Chronic tonsillitis
J35.02 Chronic adenoiditis
J35.03 Chronic tonsillitis and adenoiditis
J35.1 Hypertrophy of tonsils
J35.2 Hypertrophy of adenoids
J35.3 Hypertrophy of tonsils with hypertrophy of adenoids
J36 Peritonsillar abscess
J37.0 Chronic laryngitis
J38.01 Paralysis of vocal cords and larynx, unilateral
J38.02 Paralysis of vocal cords and larynx, bilateral
J38.1 Polyp of vocal cord and larynx
J38.2 Nodules of vocal cords
J38.3 Other diseases of vocal cords
J38.4 Edema of larynx
J38.5 Laryngeal spasm
J38.6 Stenosis of larynx
J38.7 Other disease of larynx
J96.01 Acute respiratory failure with hypoxia
J96.02 Acute respiratory failure with hypercapnia
J96.11 Chronic respiratory failure with hypoxia
J96.12 Chronic respiratory failure with hypercapnia
J96.21 Acute and chronic respiratory failure with hypoxia
J96.22 Acute and chronic respiratory failure with hypercapnia
K09.8 Other cysts of oral region, not elsewhere classified
K09.9 Cyst of oral region, unspecified
K11.21 Acute sialoadenitis
K11.22 Acute recurrent sialoadenitis
K11.23 Chronic sialoadenitis
K11.5 Sialolithiasis
K11.6 Mucocele of salivary gland
K12.30 Oral mucositis (ulcerative), unspecified
K13.0 Disease of lips
K13.4 Granuloma and granuloma-like lesions of oral mucosa
K13.6 Irritative hyperplasia of oral mucosa
K13.70 Unspecified lesions of oral mucosa
K13.79 Other lesions of oral mucosa
K14.0 Glossitis
K21.0 Gastro-esophageal reflux disease with esophagitis
K21.9 Gastro-esophageal reflux disease without esophagitis
K22.5 Diverticulum of esophagus, acquired
L03.211 Cellulitis of face
L03.221 Cellulitis of neck
L72.0 Epidermal cyst
L72.11 Pilar cyst
L72.12 Trichodermal cyst
L72.2 Steatocystoma multiplex
L72.3 Sebaceous cyst
L72.8 Other follicular cysts of the skin and subcutaneous tissue
L91.0 Hypertrophic scar
M26.60 Temporomandibular joint disorders, unspecified
M26.69 Other specified disorders of temporomandibular joint
M54.2 Cervicalgia
M95.0 Acquired deformity of nose
Q16.1 Congenital absence, atresia and stricture of auditory canal (external)
Q18.0 Sinus, fistula and cyst of branchial cleft
Q31.0 Web of larynx
Q31.1 Congenital subglottic stenosis
Q31.2 Laryngeal hypoplasia
Q31.3 Laryngocele
Q31.5 Congenital laryngomalacia
Q31.8 Other congenital malformation of larynx
Q32.0 Congenital tracheomalacia
Q32.1 Other congenital malformations of trachea
Q32.2 Congenital bronchomalacia
Q32.3 Congenital stenosis of bronchus
Q32.4 Other congenital malformations of bronchus
Q38.1 Ankyloglossia
Q89.2 Congenital malformations of other endocrine glands
R04.0 Epistaxis
R04.2 Hemoptysis
R04.89 Hemorrhage from other sites in respiratory passages
R04.9 Hemorrhage from respiratory passages, unspecified
R05 Cough
R06.00 Dyspnea, unspecified
R06.09 Other forms of dyspnea
R06.1 Stridor
R06.89 Other abnormalities of breathing
R13.10 Dysphagia, unspecified
R22.0 Localized swelling, mass and lump, head
R22.1 Localized swelling, mass and lump, neck
R42 Dizziness and giddiness
R43.0 Anosmia
R43.1 Parosmia
R43.2 Parageusia
R43.8 Other disturbance of smell and taste
R49.0 Dysphonia
R51 Headache
R59.0 Localized enlarged lymph nodes
R59.1 Generalized enlarged lymph nodes
R59.9 Enlarged lymph nodes, unspecified
S02.10XA Unspecified fracture of base of skull, initial encounter for closed fracture
S02.10XB Unspecified fracture of base of skull, initial encounter for open fracture
S02.10XD Unspecified fracture of base of skull, subsequent encounter for fracture with routine healing
S02.10XG Unspecified fracture of base of skull, subsequent encounter for fracture with delayed healing
S02.10XK Unspecified fracture of base of skull, subsequent encounter for fracture with nonunion
S02.10XS Unspecified fracture of base of skull, sequela
S02.2XXA Fracture of nasal bones, initial encounter for closed fracture
S02.2XXB Fracture of nasal bones, initial encounter for open fracture
S02.2XXD Fracture of nasal bones, subsequent encounter for fracture with routine healing
S02.2XXG Fracture of nasal bones, subsequent encounter for fracture with delayed healing
S02.2XXK Fracture of nasal bones, subsequent encounter for fracture with nonunion
S02.2XXS Fracture of nasal bones, sequela
S02.3XXA Fracture of orbital floor, initial encounter for closed fracture
S02.3XXB Fracture of orbital floor, initial encounter for open fracture
S02.3XXD Fracture of orbital floor, subsequent encounter for fracture with routine healing
S02.3XXG Fracture of orbital floor, subsequent encounter for fracture with delayed healing
S02.3XXK Fracture of orbital floor, subsequent encounter for fracture with nonunion
S02.3XXS Fracture of orbital floor, sequela
S02.401A Maxillary fracture, unspecified, initial encounter for closed fracture
S02.401B Maxillary fracture, unspecified, initial encounter for open fracture
S02.401D Maxillary fracture, unspecified, subsequent encounter for fracture with routine healing
S02.401G Maxillary fracture, unspecified, subsequent encounter for fracture with delayed healing
S02.401K Maxillary fracture, unspecified, subsequent encounter for fracture with nonunion
S02.401S Maxillary fracture, unspecified, sequela
S02.402A Zygomatic fracture, unspecified, initial encounter for closed fracture
S02.402B Zygomatic fracture, unspecified, initial encounter for open fracture
S02.402D Zygomatic fracture, unspecified, subsequent encounter for fracture with routine healing
S02.402G Zygomatic fracture, unspecified, subsequent encounter for fracture with delayed healing
S02.402K Zygomatic fracture, unspecified, subsequent encounter for fracture with nonunion
S02.402S Zygomatic fracture, unspecified, sequela
S02.411A LeFort I fracture, initial encounter for closed fracture
S02.411B LeFort I fracture, initial encounter for open fracture
S02.411D LeFort I fracture, subsequent encounter for fracture with routine healing
S02.411G LeFort I fracture, subsequent encounter for fracture with delayed healing
S02.411K LeFort I fracture, subsequent encounter for fracture with nonunion
S02.411S LeFort I fracture, sequela
S02.413A LeFort III fracture, initial encounter for closed fracture
S02.413B LeFort III fracture, initial encounter for open fracture
S02.413D LeFort III fracture, subsequent encounter for fracture with routine healing
S02.413G LeFort III fracture, subsequent encounter for fracture with delayed healing
S02.413K LeFort III fracture, subsequent encounter for fracture with nonunion
S02.413S LeFort III fracture, sequela
S02.42XA Fracture of alveolus maxilla, initial encounter for closed fracture
S02.42XB Fracture of alveolus maxilla, initial encounter for open fracture
S02.42XD Fracture of alveolus maxilla, subsequent encounter for fracture with routine healing
S02.402G Zygomatic fracture, unspecified, subsequent encounter for fracture with delayed healing
S02.402K Zygomatic fracture, unspecified, subsequent encounter for fracture with nonunion
S02.402S Zygomatic fracture, unspecified, sequela
S02.411A LeFort I fracture, initial encounter for closed fracture
S02.411B LeFort I fracture, initial encounter for open fracture
S02.411D LeFort I fracture, subsequent encounter for fracture with routine healing
S02.411G LeFort I fracture, subsequent encounter for fracture with delayed healing
S02.411K LeFort I fracture, subsequent encounter for fracture with nonunion
S02.411S LeFort I fracture, sequela
S02.413A LeFort III fracture, initial encounter for closed fracture
S02.413B LeFort III fracture, initial encounter for open fracture
S02.413D LeFort III fracture, subsequent encounter for fracture with routine healing
S02.413G LeFort III fracture, subsequent encounter for fracture with delayed healing
S02.413K LeFort III fracture, subsequent encounter for fracture with nonunion
S02.413S LeFort III fracture, sequela
S02.42XA Fracture of alveolus maxilla, initial encounter for closed fracture
S02.42XB Fracture of alveolus maxilla, initial encounter for open fracture
S02.42XD Fracture of alveolus maxilla, subsequent encounter for fracture with routine healing
S02.413D LeFort III fracture, subsequent encounter for fracture with routine healing
S02.413G LeFort III fracture, subsequent encounter for fracture with delayed healing
S02.413K LeFort III fracture, subsequent encounter for fracture with nonunion
S02.413S LeFort III fracture, sequela
S02.42XA Fracture of alveolus maxilla, initial encounter for closed fracture
S02.42XB Fracture of alveolus maxilla, initial encounter for open fracture
S02.42XD Fracture of alveolus maxilla, subsequent encounter for fracture with routine healing
S02.42XG Fracture of alveolus maxilla, subsequent encounter for fracture with delayed healing
S02.42XK Fracture of alveolus maxilla, subsequent encounter for fracture with nonunion
S02.42XS Fracture of alveolus maxilla, sequela
S09.21XA Traumatic rupture of right ear drum, initial encounter
S09.21XD Traumatic rupture of right ear drum, subsequent encounter
S09.21XS Traumatic rupture of right ear drum, sequela
S09.22XA Traumatic rupture of left ear drum, initial encounter
S09.22XD Traumatic rupture of left ear drum, subsequent encounter
S09.22XS Traumatic rupture of left ear drum, sequela
S09.92XA Unspecified injury of nose, initial encounter
S09.92XD Unspecified injury of nose, subsequent encounter
S09.92XS Unspecified injury of nose, sequela
S09.93XA Unspecified injury of face, initial encounter
S09.93XD Unspecified injury of face, subsequent encounter
S09.93XS Unspecified injury of face, sequela
S16.8XXA Other specified injury of muscle, fascia and tendon at neck level, initial encounter
S16.8XXD Other specified injury of muscle, fascia and tendon at neck level, subsequent encounter
S16.8XXS Other specified injury of muscle, fascia and tendon at neck level, sequela
S19.81XA Other specified injuries of larynx, initial encounter
S19.81XD Other specified injuries of larynx, subsequent encounter
S19.81XS Other specified injuries of larynx, sequela
S19.82XA Other specified injuries of cervical trachea, initial encounter
S19.82XD Other specified injuries of cervical trachea, subsequent encounter
S19.82XS Other specified injuries of cervical trachea, sequela
S19.83XA Other specified injuries of vocal cord, initial encounter
S19.83XD Other specified injuries of vocal cord, subsequent encounter
S19.83XS Other specified injuries of vocal cord, sequela
S19.84XA Other specified injuries of thyroid gland, initial encounter
S19.84XD Other specified injuries of thyroid gland, subsequent encounter
S19.84XS Other specified injuries of thyroid gland, sequela
S19.85XA Other specified injuries of pharynx and cervical esophagus, initial encounter
S19.85XD Other specified injuries of pharynx and cervical esophagus, subsequent encounter
S19.85XS Other specified injuries of pharynx and cervical esophagus, sequela
S19.9XXA Unspecified injury of neck, initial encounter
S19.9XXD Unspecified injury of neck, subsequent encounter
S19.9XXS Unspecified injury of neck, sequela
T16.1XXA Foreign body in right ear, initial encounter
T16.1XXD Foreign body in right ear, subsequent encounter
T16.1XXS Foreign body in right ear, sequela
T16.2XXA Foreign body in left ear, initial encounter
T16.2XXD Foreign body in left ear, subsequent encounter
T16.2XXS Foreign body in left ear, sequela
T17.0XXA Foreign body in nasal sinus, initial encounter
T17.0XXD Foreign body in nasal sinus, subsequent encounter
T17.0XXS Foreign body in nasal sinus, sequela
T17.1XXA Foreign body in nostril, initial encounter
T17.1XXD Foreign body in nostril, subsequent encounter
T17.1XXS Foreign body in nostril, sequela
Z01.10 Encounter for examination of ears and hearing without abnormal findings
Z01.110 Encounter for hearing examination following failed hearing screening
Z01.118 Encounter for examination of ears and hearing with other abnormal findings
Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
Z09 Encounter for follow-up examination after completed treatment for condition other than malignant neoplasm
Z43.0 Encounter for attention to tracheostomy
Z44.8 Encounter for fitting and adjustment of other external prosthetic devices
Z71.1 Person with feared health complaint in whom no diagnosis is made
Z79.899 Other long term (current) drug therapy
Z09 Encounter for follow-up examination after completed treatment for condition other than malignant neoplasm
Z43.0 Encounter for attention to tracheostomy
Z44.8 Encounter for fitting and adjustment of other external prosthetic devices
Z71.1 Person with feared health complaint in whom no diagnosis is made
Z79.899 Other long term (current) drug therapy
Z09 Encounter for follow-up examination after completed treatment for condition other than malignant neoplasm
Z43.0 Encounter for attention to tracheostomy
Z44.8 Encounter for fitting and adjustment of other external prosthetic devices
Z71.1 Person with feared health complaint in whom no diagnosis is made
Z79.899 Other long term (current) drug therapy
Disclaimer: This sample ICD-10 superbill is designed to assist otolaryngology practices in quickly completing and submitting procedure(s) and diagnosis(s) codes from a patient visit for reimbursement. It is generally customized for an otolaryngology office and contains fields for patient information, the most common CPT (procedure) and ICD-10-CM (diagnostic) codes used by Otolaryngologists. Members should note that this superbill is designed solely as an exercise in demonstrating the process of transitioning to the new ICD-10-CM coding system, and does not represent an endorsement by the Academy of the use of superbills or this particular superbill format. For more information on the transition to ICD-10 please contact the health policy team at: [email protected].