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H65.412 ICD-10-CM Code: Chronic allergic otitis media, left ear

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

Coding at a Glance

Tabular directives
1 inclusion term · 9 use-additional codes

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 152 — OTITIS MEDIA AND URI WITH MCC (MDC 03)
  • MS-DRG 153 — OTITIS MEDIA AND URI WITHOUT 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H65.412 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on H65.412 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • nonsuppurative otitis media with myringitis

Source: inherited from H65

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for any associated perforated tympanic membrane (H72.-)
  • Use additional 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)

Source: inherited from H65

Coder workflow for H65.412

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

Before you code H65.412

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: left). 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).

    ReviewH65.411 · right, H65.413 · bilateral, H65.419 · unspecified

    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.

    ReviewH65.411 · right, H65.413 · bilateral, H65.419 · unspecified

Consider H65.412. Then work the Use Additional Code note, and 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).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Use Additional Code — after identifying H65.412(9 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with H65.412 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewH72, Z77.22, P96.81, Z87.891, Z57.31, F17

    See the official tabular notes · Guidelines I.A.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).

ReviewH65.411 · right, H65.413 · bilateral, H65.419 · unspecified

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with H65.412?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewH72, Z77.22, P96.81, Z87.891, Z57.31, F17

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

Chronic allergic otitis media, left ear is a billable ICD-10-CM diagnosis code (H65.412).

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

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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 H65.412 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 2 Code First instructions across 2 chapters: B97.4 — Respiratory syncytial virus as the cause of diseases classified elsewhere (via H65.-), H72 — Perforation of tympanic membrane (via H65.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

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 2 MS-DRGs: DRG 152 (MDC 03), DRG 153 (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):EAR001 — Otitis media (default); INJ031 — Allergic reactions.

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 condition, opposite side

Same category and title, differing only in which side of the body is affected.

H65.411 — Chronic allergic otitis media, right ear (right)Compare H65.412 vs H65.411 →, H65.413 — Chronic allergic otitis media, bilateral (bilateral)Compare H65.412 vs H65.413 →, H65.419 — Chronic allergic otitis media, unspecified ear (unspecified)Compare H65.412 vs H65.419 →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Otitis media, Allergic reactions).

H65.199 — Other acute nonsuppurative otitis media, unspecified ear, H65.20 — Chronic serous otitis media, unspecified ear, H65.21 — Chronic serous otitis media, right ear, H65.22 — Chronic serous otitis media, left ear, H65.23 — Chronic serous otitis media, bilateral, H65.30 — Chronic mucoid otitis media, unspecified ear, H65.31 — Chronic mucoid otitis media, right ear, H65.32 — Chronic mucoid otitis media, left ear, H65.33 — Chronic mucoid otitis media, bilateral, H65.411 — Chronic allergic otitis media, right ear, H65.413 — Chronic allergic otitis media, bilateral, H65.419 — Chronic allergic otitis media, unspecified ear, H65.491 — Other chronic nonsuppurative otitis media, right ear, H65.492 — Other chronic nonsuppurative otitis media, left ear, H65.493 — Other chronic nonsuppurative otitis media, bilateral, H65.499 — Other chronic nonsuppurative otitis media, unspecified ear, H65.90 — Unspecified nonsuppurative otitis media, unspecified ear, H65.91 — Unspecified nonsuppurative otitis media, right ear, H65.92 — Unspecified nonsuppurative otitis media, left ear, H65.93 — Unspecified nonsuppurative otitis media, bilateral, +169 more

Same Index main term, other category

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

H60.32 — Hemorrhagic otitis externa (externa, infective NEC, hemorrhagic), H60.39 — Other infective otitis externa (externa, infective NEC), H60.50 — Unspecified acute noninfective otitis externa (externa, acute), H60.51 — Acute actinic otitis externa (externa, acute, actinic), H60.52 — Acute chemical otitis externa (externa, acute, chemical), H60.53 — Acute contact otitis externa (externa, acute, contact), H60.54 — Acute eczematoid otitis externa (externa, acute, eczematoid), H60.55 — Acute reactive otitis externa (externa, acute, reactive), H60.59 — Other noninfective acute otitis externa (externa, acute, specified NEC), H60.6 — Unspecified chronic otitis externa (externa, chronic), H60.9 — Unspecified otitis externa (externa), H66.00 — Acute suppurative otitis media without spontaneous rupture of ear drum (media, suppurative, acute), H66.01 — Acute suppurative otitis media with spontaneous rupture of ear drum (media, suppurative, acute, with rupture of ear drum), H66.1 — Chronic tubotympanic suppurative otitis media (media, suppurative, chronic, tubotympanic), H66.2 — Chronic atticoantral suppurative otitis media (media, suppurative, chronic, atticoantral), H66.3 — Other chronic suppurative otitis media (media, suppurative, chronic), H66.4 — Suppurative otitis media, unspecified (media, suppurative), H66.9 — Otitis media, unspecified (media), H66.90 — Otitis media, unspecified, unspecified ear, L01.00 — Impetigo, unspecified (externa, in, impetigo), +14 more

Contextual Map

Every relationship of H65.412 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 H65.412 with these 2 related codes in Claim Check

Hierarchy

Referenced by Code First instructions

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

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. "H65.412 — Chronic allergic otitis media, left ear." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/h65.412-chronic-allergic-otitis-media-left-ear

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Chronic allergic otitis media, left ear

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 H65.412 in its code family, with their registry titles.

View all codes in the H65 family