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