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H61.23 ICD-10-CM Code: Impacted cerumen, bilateral

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 154 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC (MDC 03)
  • MS-DRG 155 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC (MDC 03)
  • MS-DRG 156 — OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC (MDC 03)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coder workflow for H61.23

MedCoder structured workflow — derived from this code’s own official record

Before you code H61.23

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: bilateral). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

Choose the right path

  1. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider H61.23. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Impacted cerumen, bilateral is a billable ICD-10-CM diagnosis code (H61.23).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 8: Diseases of the Ear and Mastoid Process (H60-H95)

Reserved for future guideline expansion

Verify Before Coding

  • Questionable admission. The Medicare Code Editor lists this among its questionable-admission codes: reported as the principal diagnosis, it is not usually sufficient justification for an inpatient admission on its own, so it flags the admission as questionable. The code itself remains acceptable as principal.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name H61.23 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: H91 — Other and unspecified hearing loss (via H61.2.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 154 (MDC 03), DRG 155 (MDC 03), DRG 156 (MDC 03).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):EAR006 — Other specified and unspecified disorders of the ear (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified disorders of the ear).

H61.122 — Hematoma of pinna, left ear, H61.123 — Hematoma of pinna, bilateral, H61.129 — Hematoma of pinna, unspecified ear, H61.191 — Noninfective disorders of pinna, right ear, H61.192 — Noninfective disorders of pinna, left ear, H61.193 — Noninfective disorders of pinna, bilateral, H61.199 — Noninfective disorders of pinna, unspecified ear, H61.20 — Impacted cerumen, unspecified ear, H61.21 — Impacted cerumen, right ear, H61.22 — Impacted cerumen, left ear, H61.301 — Acquired stenosis of right external ear canal, unspecified, H61.302 — Acquired stenosis of left external ear canal, unspecified, H61.303 — Acquired stenosis of external ear canal, unspecified, bilateral, H61.309 — Acquired stenosis of external ear canal, unspecified, unspecified ear, H61.311 — Acquired stenosis of right external ear canal secondary to trauma, H61.312 — Acquired stenosis of left external ear canal secondary to trauma, H61.313 — Acquired stenosis of external ear canal secondary to trauma, bilateral, H61.319 — Acquired stenosis of external ear canal secondary to trauma, unspecified ear, H61.321 — Acquired stenosis of right external ear canal secondary to inflammation and infection, H61.322 — Acquired stenosis of left external ear canal secondary to inflammation and infection, +190 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Impaction, impacted”, “Ear”; these codes share that main term but sit in a different category of the Tabular List.

B36.9 — Superficial mycosis, unspecified (tropical NEC), B37.84 — Candidal otitis externa (tropical NEC, in, moniliasis), B44.89 — Other forms of aspergillosis (tropical NEC, in, aspergillosis), J34.89 — Other specified disorders of nose and nasal sinuses (turbinate), K01.1 — Impacted teeth (dental), K56.3 — Gallstone ileus (bowel, colon, rectum, by gallstone), K56.41 — Fecal impaction (fecal, feces), K56.49 — Other impaction of intestine (intestine NEC), O66.0 — Obstructed labor due to shoulder dystocia (shoulder, causing obstructed labor), T83.39 — Other mechanical complication of intrauterine contraceptive device (intrauterine device), Z41.3 — Encounter for ear piercing (piercing)

Contextual Map

Every relationship of H61.23 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run H61.23 with this related code in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat[MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,147 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Ear, wax (impacted), left, with right[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Ear, wax (impacted), right, with left[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "H61.23 — Impacted cerumen, bilateral." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/h61.23-impacted-cerumen-bilateral

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Impacted cerumen, bilateral

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H61.23 in its code family, with their registry titles.

View all codes in the H61 family