Ear pain, or otalgia, is one of the most common reasons patients visit urgent care or ENT clinics. Whether in the left ear, right ear, or both, choosing the correct ICD-10 code for ear pain is essential for accurate documentation, clean billing, and faster insurance approval.
In this 2025 coding guide, we break down the top ICD-10 codes for ear pain, including chronic cases, bilateral discomfort, and pregnancy situations. If you’re a provider, biller, or medical coder, this post will help you avoid denials and stay fully compliant.
The general ICD-10 code for ear pain is H92.0, categorized under otalgia, which refers to pain in the ear. This code group is further divided by laterality, left, right, or bilateral.
If a patient presents with pain in the right ear, the correct diagnosis code is:
This is one of the most searched codes for good reason. It’s used frequently in outpatient ENT clinics, primary care, and pediatrics. Not coding laterality can result in claim rejections or downcoding, so always specify the ear involved.
Similarly, for left ear pain, the code you’ll need is:
This code is particularly important in older patients or those with chronic conditions, where documentation of laterality helps track recurring issues or treatment effectiveness.
When both ears are hurting, the accurate ICD-10 code is:
This code is vital when the diagnosis includes middle ear infections, Eustachian tube dysfunction, or barotrauma that affects both ears. Always make sure the documentation supports bilateral symptoms.
Now, let’s say the patient has chronic otalgia with no underlying infection or structural issue. In that case, while ICD-10 doesn’t provide a specific chronic ear pain code, you can pair H92.01, H92.02, or H92.03 with a chronic pain modifier (like G89.29) if medically necessary.
Always check payer-specific guidelines before pairing chronic pain codes with otalgia.
Sometimes, documentation might be vague, especially in telemedicine visits or walk-in clinics. If the provider doesn’t document which ear hurts, use:
However, this code is less ideal for billing. Insurers increasingly require specificity, so encourage providers to document clearly.
If a pregnant patient complains of ear pain, you may need to code both the ear pain and the pregnancy-related complication. For example:
Update the trimester as needed. Use a combination of the ear pain ICD-10 code and the pregnancy complication code to support accurate claims.
Our goal is to streamline your healthcare revenue cycle management, give you the financial freedom your practice deserves, and take control with a partner specializing in provider RCM optimization and service excellence.
Fill out the form below and we’ll contact you shortly.
The term “otalgia” is simply the clinical term for ear pain. All H92.0x codes listed above are grouped under otalgia ICD-10 codes. You might also come across these variations:
Tip: Always use the term that matches the provider’s documentation to support your coding choices.
Condition | ICD-10 Code | Description |
Right Ear Pain | H92.01 | Otalgia, right ear |
Left Ear Pain | H92.02 | Otalgia, left ear |
Bilateral Ear Pain | H92.03 | Otalgia, both ears |
Unspecified Ear Pain | H92.09 | Otalgia, unspecified ear |
Chronic Ear Pain | H92.01–H92.03 + G89.29 (if applicable) | Use with caution, based on documentation |
Ear Pain in Pregnancy | H92.0x + O26.891 | Add trimester code |
Otalgia (general term) | H92.0x | Use based on the affected ear |
To reduce billing errors:
If your claim is denied, check the payer’s LCD/NCD (Local or National Coverage Determination) to verify if supporting diagnoses or documentation are required.
In conclusion, using the correct ICD-10 code for ear pain is more than just selecting a number; it’s about understanding the full clinical picture and aligning it with coding rules for 2025. Whether you’re dealing with a simple earache or complex bilateral otalgia during pregnancy, this guide ensures your codes are clean, your claims go through, and your revenue stays healthy.
Need help with ENT or primary care billing? CuresMB offers accurate, affordable medical coding and billing services for clinics of all sizes.
Use O99.89 alongside trimester-specific obstetric codes (e.g., Z3A.00 for first trimester).
Yes. Use H93.1X9 (tinnitus) and H92.0-* for pain if both are documented.
H92.031 (chronic bilateral otalgia). Always confirm chronicity in patient records.
Discover Cures Medical Billing Services Across Different States
FL
NY
ML
CO
NJ
AZ
TX
CA
WA
We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.
Medical billing around Astoria, NY, and beyond is our core competency and our specialists will efficiently manage all your billing needs. Our medical billing specialists have over 12 Plus years of experience with all security technologies to ensure data integrity for our customers. Using our medical billing service, anyone can make their medical billing task less resource-consuming.
Discover unparalleled efficiency and precision in healthcare financial management with Cures Medical Billing Solutions.
© 2024 Created Cures Medical Billing Solutions, All copyrights Reserved
Want a free consultation or pricing guide? Send the info or call now for billing information.
