Question 1

What is ICD-10 code H60.502?

Accepted Answer

H60.502 is the ICD-10-CM diagnosis code for unspecified acute noninfective otitis externa, left ear. Sudden inflammation of the outer ear canal on the left side that is not caused by infection, with no specific underlying cause identified. H60.502 sits in the ICD-10-CM chapter for diseases of the ear and mastoid process (h60-h95), within the section covering diseases of external ear (h60-h62).

H60.502 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code when acute otitis externa is confirmed as noninfective but the specific cause cannot be determined.

Question 2

Is H60.502 an HCC code?

Accepted Answer

No. H60.502 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is H60.502 billable?

Accepted Answer

Yes. H60.502 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H60.502 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for H60.502?

Accepted Answer

H60.502 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H60.502 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting H60.502?

Accepted Answer

Use this code when acute otitis externa is confirmed as noninfective but the specific cause cannot be determined Ensure documentation specifies left ear laterality; if bilateral or unspecified, use different codes H60.503 or H60.509

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H60.502

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H60.502 ICD-10-CM Code: Unspecified acute noninfective otitis externa, left ear

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H60.502

Is H60.502 an HCC code?

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Open H60.502 in the Interactive Encoder