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H65.32 vs H74.1

H65.32 (Chronic mucoid otitis media, left ear) compared with H74.1 (Adhesive middle ear disease), 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 28, 2026 · All releases and sources

Summary

These codes should not be reported together because H65.32’s tabular entry lists H74.1 under Excludes1.

Official rule
What is different?

The conditions named and billing status.H65.32 is “Chronic mucoid otitis media, left ear”; H74.1 is “Adhesive middle ear disease”. H74.1 is a non-billable header; H65.32 is billable.

Registry fact

Can these codes be reported together?

No.H65.32’s entry carries an Excludes1 note covering H74.1: “adhesive middle ear disease (H74.1)”. 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.H65.32’s tabular entry: “adhesive middle ear disease (H74.1)”. The note covers H74.1.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.H74.1 is a non-billable header, but H65.32 is not one of its subdivisions.

Registry fact

Nothing found in 3 other checks; 1 check does not apply
Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. H74.1 carries 1 Excludes2 note covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

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

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

H65.32
Chronic mucoid otitis media, left ear
↔
H74.1
Adhesive middle ear disease

What we found

No — do not report together.H65.32 carries an Excludes1 note covering H74.1: “adhesive middle ear disease (H74.1)”

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

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
H65.32

Chronic mucoid otitis media, left ear

H74.1

Adhesive middle ear disease

StatusDiffers
H65.32
Billable
H74.1
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: H74.11, H74.12, H74.13, H74.19

Excludes1Differs
H65.32
  • adhesive middle ear disease (H74.1)
H74.1
  • glue ear (H65.3-)
Excludes2Differs
H65.32

None at this code

H74.1
  • mastoiditis (H70.-)
Use additional codeDiffers
H65.32
  • code for any associated perforated tympanic membrane (H72.-)
  • code, if applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • infectious agent (B95-B97)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
H74.1

None at this code

CategoryDiffers
H65.32

H65 Nonsuppurative otitis media

H74.1

H74 Other disorders of middle ear mastoid

ChapterSame for both

H60-H95 — Diseases of the Ear and Mastoid Process (H60-H95)

IncludesDiffers
H65.32
  • nonsuppurative otitis media with myringitis
H74.1
  • Adhesive otitis

No Code first, Code also and 7th character note at either code.

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. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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