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Otitis Media F015

Last amended 
14 July 2022

In this section

Current RMA Instruments
Reasonable Hypothesis SOP
62 of 2022
Balance of Probabilities SOP
63 of 2022
Changes from previous Instruments

SOP Bulletin 231

ICD Coding
  • ICD-10-AM Codes: H65, H66, H67
Brief description

This is an inflammation of the middle part of the ear.  It is most often infective but there are non-infective causes.  It may be an acute or chronic condition.  It is usually unilateral.

Confirming the diagnosis

This diagnosis is made on clinical grounds, by inspection of the ear with an otoscope, and can be made by a treating GP. 

The relevant medical specialist is an Ear, Nose and Throat (ENT) surgeon.

Diagnoses covered by SOP
  • All forms of otitis media, e.g. acute, chronic, serous, purulent, secretory
  • Middle ear infection
Conditions excluded from SOP
  • Cholesteatoma#
  • Mastoiditis#
  • Otitis externa*
  • Perforation of tympanic membrane#

* Another SOP applies

# Non-SOP condition

Clinical onset

The onset of acute otitis media in adults is typically associated with otalgia (ear pain) and decreased hearing.  Chronic otitis media will have been preceded by acute otitis media.  Chronic otitis media features painless recurrent or persistent discharge from the ear (through a perforated tympanic membrane).

Clinical worsening

Clinical worsening will generally only be relevant for chronic or relapsing otitis media.