Vestibular neuronitis, bilateral

This code describes inflammation of the vestibular nerve affecting both ears, leading to sudden, severe vertigo, nausea, vomiting, and imbalance without associated hearing loss. It is a peripheral vestibular disorder resulting from viral infection or other inflammatory processes.

Assign this code when documentation explicitly states a diagnosis of vestibular neuronitis affecting both the left and right vestibular nerves. Supporting documentation should detail the acute onset of vertigo and other associated symptoms, along with findings that rule out central nervous system involvement or other causes of bilateral vestibular dysfunction.

• Ensure documentation specifies "bilateral" involvement; otherwise, a unilateral code (H81.21 or H81.22) or unspecified code (H81.20) may be more appropriate.
• Differentiate from labyrinthitis, which typically includes hearing loss, and Ménière's disease, which involves recurrent episodes and fluctuating hearing loss.
• Look for physician notes indicating a viral prodrome or other inflammatory etiology.