ICD-10 code for middle ear anomaly

The ICD-10-CM code for middle ear anomaly is Q16.4 (Other congenital malformations of middle ear). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on Q16.4.

Within Q16, choose Q16.4 (Other congenital malformations of middle ear) only when documentation doesn't support a more specific option: congenital absence of (ear) auricle (Q16.0), congenital absence, atresia and stricture of auditory canal (external) (Q16.1), absence of eustachian tube (Q16.2), congenital malformation of ear ossicles (Q16.3), congenital malformation of inner ear (Q16.5) and congenital malformation of ear causing impairment of hearing, unspecified (Q16.9).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 154 (Other Ear, Nose, Mouth and Throat Diagnoses with MCC, relative weight 1.5921), DRG 155 (Other Ear, Nose, Mouth and Throat Diagnoses with CC, relative weight 0.9322) and DRG 156 (Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC, relative weight 0.6659), in MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.