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H65.19 vs H66.9

H65.19 (Other acute nonsuppurative otitis media) compared with H66.9 (Otitis media, unspecified), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Summary

These codes should not be reported together because H65.19’s tabular entry lists H66.9 under Excludes1.

Official rule
What is different?

The conditions named.H65.19 is “Other acute nonsuppurative otitis media”; H66.9 is “Otitis media, unspecified”.

Registry fact

Can these codes be reported together?

No.H65.19’s entry carries an Excludes1 note covering H66.9: “otitis media (acute) NOS (H66.9)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.H65.19’s tabular entry: “otitis media (acute) NOS (H66.9)”. The note covers H66.9.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

H65.19
Other acute nonsuppurative otitis media
↔
H66.9
Otitis media, unspecified

What we found

No — do not report together.H65.19 carries an Excludes1 note covering H66.9: “otitis media (acute) NOS (H66.9)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

H65.19Other acute nonsuppurative otitis mediaH66.9Otitis media, unspecified
Billing statusNon-billable header

Report instead: H65.191, H65.192, H65.193, H65.194, H65.195

Non-billable header

Report instead: H66.90, H66.91, H66.92, H66.93

ClassificationH60-H95 — Diseases of the Ear and Mastoid Process (H60-H95)H60-H95 — Diseases of the Ear and Mastoid Process (H60-H95)
DefinitionOther acute nonsuppurative otitis media is a non-billable ICD-10-CM category code (H65.19).Otitis media, unspecified is a non-billable ICD-10-CM category code (H66.9).
Includes
nonsuppurative otitis media with myringitis
Acute and subacute mucoid otitis media
Acute and subacute nonsuppurative otitis media NOS
Acute and subacute sanguinous otitis media
suppurative and unspecified otitis media with myringitis
Otitis media NOS
Acute otitis media NOS
Chronic otitis media NOS
Excludes1
otitic barotrauma (T70.0)
otitis media (acute) NOS (H66.9)
—
Use additional code
code for any associated perforated tympanic membrane (H72.-)
code, if applicable, to identify:
exposure to environmental tobacco smoke (Z77.22)
code for any associated perforated tympanic membrane (H72.-)
code to identify:
exposure to environmental tobacco smoke (Z77.22)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources