H61 ICD-10-CM Code: Other disorders of external ear
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FY 2026 Apr update / Diseases of the ear and mastoid process (H60-H95) / Diseases of external ear (H60-H62)
H61
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther disorders of external ear
Other disorders of external ear
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
Code Trumping
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H61 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H61 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H61 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H61 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H61 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H61 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H61 in this effective period.
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.
What This Code Means
H61 is the ICD-10-CM diagnosis code for other disorders of external ear. H61 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).
Header codes like H61 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H61's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H61 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.