Cholesteatoma of tympanum, unspecified ear

This code signifies a cholesteatoma, which is an abnormal, noncancerous skin growth that can develop behind the eardrum, specifically within the tympanum. It is characterized by a cyst-like sac that sheds old skin cells, leading to an accumulation of debris that can expand and erode surrounding bone. This particular code is used when the affected ear is not specified in the medical record.

Apply this code when documentation confirms a cholesteatoma located in the tympanum, and the laterality (left or right ear) is not documented. This diagnosis is typically supported by otoscopic examination findings, imaging studies (e.g., CT scan), and surgical pathology reports.

• Do not use this code if the laterality of the cholesteatoma is documented; instead, select a more specific code (H71.11-H71.13).
• Distinguish from other middle ear conditions like otitis media with effusion or tympanosclerosis, which have different underlying pathologies.
• Always review operative reports for definitive diagnosis and location when surgical intervention occurs.