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H90.5 – Mixed Hearing Loss ICD-10 Code
H90.5 is an ICD-10 diagnosis code for unspecified mixed conductive and sensorineural hearing loss. It describes bilateral hearing loss of unclear or combined origin.
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H90.5 is an ICD-10 diagnosis code for unspecified mixed conductive and sensorineural hearing loss. It describes bilateral hearing loss of unclear or combined origin.
What does the diagnosis code H90.5 mean?
The ICD-10 code H90.5 refers to unspecified mixed conductive and sensorineural hearing loss. It is used when a patient presents with features of both conductive hearing loss (a problem in the outer or middle ear) and sensorineural hearing loss (damage to the inner ear or auditory nerve), but the documentation does not specify the side or the precise underlying cause.
Types of hearing loss
Conductive hearing loss
Conductive hearing loss occurs when sound waves cannot be transmitted efficiently through the outer ear canal, eardrum, or middle ear ossicles to the inner ear. Common causes include:
- Earwax blockage (cerumen impaction)
- Middle ear infection (otitis media)
- Perforated eardrum
- Otosclerosis (abnormal bone growth in the middle ear)
Sensorineural hearing loss
Sensorineural hearing loss results from damage to the hair cells of the cochlea or the auditory nerve. Common causes include:
- Age-related hearing loss (presbycusis)
- Noise-induced hearing loss
- Ménière disease
- Viral infections (e.g., measles, mumps)
- Ototoxic medications (e.g., certain antibiotics or chemotherapy drugs)
Mixed hearing loss
Mixed hearing loss, represented by code H90.5, involves a simultaneous combination of both components. The extent of each component varies from patient to patient.
Symptoms
Affected individuals commonly report:
- Reduced hearing ability in one or both ears
- Difficulty understanding speech, especially in noisy environments
- Tinnitus (ringing or buzzing in the ears)
- A feeling of pressure or fullness in the ear
- Dizziness or vertigo (in some cases)
Diagnosis
The following examinations are used to establish the diagnosis:
- Audiometry: Measurement of the hearing threshold across different frequency ranges
- Tympanometry: Assessment of middle ear function
- Tuning fork tests: Preliminary tests to differentiate between conductive and sensorineural components
- Imaging: CT or MRI of the temporal bone when a structural cause is suspected
Treatment
Treatment is guided by the underlying cause of each component:
- Conductive component: Surgical procedures (e.g., myringotomy, tympanoplasty), removal of earwax
- Sensorineural component: Hearing aids, or cochlear implant for severe-to-profound loss
- Mixed hearing loss: A combination of medical, surgical, and audiological rehabilitation measures
Early diagnosis and appropriate intervention are essential to improve quality of life and prevent secondary consequences such as social isolation or cognitive decline.
References
- World Health Organization (WHO): International Classification of Diseases, 10th Revision (ICD-10). Geneva: WHO, 2019.
- Bhattacharyya N: Clinical practice guideline: Sudden hearing loss. Otolaryngology – Head and Neck Surgery, 2012; 146(3 Suppl): S1–S35.
- Cunningham LL, Tucci DL: Hearing Loss in Adults. New England Journal of Medicine, 2017; 377(25): 2465–2473.
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