Tuberculosis of (inner) (middle) ear

This code signifies a tuberculous infection specifically affecting the structures of the middle or inner ear. This can manifest as granulomatous inflammation, ossicular destruction, or labyrinthine involvement due to Mycobacterium tuberculosis.

Apply this code when documentation clearly indicates tuberculosis as the etiology for conditions such as chronic otitis media, labyrinthitis, or hearing loss originating from the middle or inner ear. Supporting documentation should include positive cultures for M. tuberculosis, histological findings, or clinical diagnosis of tuberculous otitis media or labyrinthitis.

• Differentiate carefully from tuberculous mastoiditis (A18.03), which is excluded from this code.
• Ensure the documentation specifies "inner" or "middle" ear involvement; tuberculosis of the external ear (A18.4) is a separate exclusion.
• Always sequence this code as a primary diagnosis when it is the reason for the encounter, or as a secondary diagnosis if it is a co-morbidity impacting treatment.