Unspecified cholesteatoma, bilateral

This code signifies the presence of an unspecified cholesteatoma affecting both ears. A cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle ear behind the eardrum, potentially eroding bone and causing hearing loss or other complications. The "unspecified" nature indicates that the specific type or origin of the cholesteatoma (e.g., congenital, acquired) is not documented.

This code is appropriate when documentation confirms the diagnosis of cholesteatoma in both the left and right ears, but lacks further specificity regarding its type or etiology. It should be used when the provider's notes clearly state "bilateral cholesteatoma" without additional details that would allow for a more precise code.

• Avoid using this code if the documentation specifies the type of cholesteatoma (e.g., congenital, attic, mastoid); instead, select a more specific code.
• Ensure the medical record explicitly states involvement of both ears; otherwise, use a unilateral or unspecified ear code.
• Query the provider for further specificity if the documentation is vague but suggests a more precise diagnosis might be available.