Malignant otitis externa, bilateral

This code signifies a severe, invasive infection of the external auditory canal and surrounding structures, caused by Pseudomonas aeruginosa, affecting both ears. It is characterized by osteomyelitis of the temporal bone, often extending to the skull base, and is particularly prevalent in immunocompromised individuals.

Apply this code when documentation clearly indicates a diagnosis of malignant otitis externa affecting both the left and right ears. Supporting documentation should detail the infectious process, involvement of bone or soft tissue beyond the external auditory canal, and the bilateral nature of the condition.

• Ensure documentation specifies "bilateral" involvement; otherwise, use the appropriate unilateral code.
• Always sequence this code as a primary diagnosis when it is the reason for the encounter.
• Consider additional codes for underlying conditions like diabetes mellitus (E10-E11) or immunocompromised states (e.g., B20 for HIV disease) that often predispose patients to this severe infection.