HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the ear and mastoid process (H60-H95) / Diseases of external ear (H60-H62)
H61.192
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNoninfective disorders of pinna, left ear
This code describes a non-infectious problem affecting the outer ear (pinna) on the left side, such as structural damage, deformity, or other conditions not caused by infection. Examples include trauma, keloids, or other benign disorders of the ear cartilage and skin.
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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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H61.192 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H61.192 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H61.192 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H61.192 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H61.192 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H61.192 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H61.192 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 H61.192 an HCC code?
No. H61.192 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
H61.192 is the ICD-10-CM diagnosis code for noninfective disorders of pinna, left ear. This code describes a non-infectious problem affecting the outer ear (pinna) on the left side, such as structural damage, deformity, or other conditions not caused by infection. Examples include trauma, keloids, or other benign disorders of the ear cartilage and skin. H61.192 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).
H61.192 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.
Verify the condition is specifically noninfective; if infection is present, use a different code from the H61.0x series.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H61.192 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.