H60.511 ICD-10-CM Code: Acute actinic otitis externa, right ear
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FY 2026 Apr update / Diseases of the ear and mastoid process (H60-H95) / Diseases of external ear (H60-H62)
H60.511
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcute actinic otitis externa, right ear
Sudden inflammation of the outer ear canal on the right side caused by sun exposure or ultraviolet radiation damage.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H60.511 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H60.511 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H60.511 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H60.511 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H60.511 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H60.511 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H60.511 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H60.511 an HCC code?
No. H60.511 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H60.511 is the ICD-10-CM diagnosis code for acute actinic otitis externa, right ear. Sudden inflammation of the outer ear canal on the right side caused by sun exposure or ultraviolet radiation damage. H60.511 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).
H60.511 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.
This code is used specifically for actinic (sun-related) otitis externa; ensure documentation mentions sun exposure or UV damage.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H60.511 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.