H61.199 ICD-10-CM Code: Noninfective disorders of pinna, unspecified ear

H61.199 is the ICD-10-CM diagnosis code for noninfective disorders of pinna, unspecified ear. This code describes a non-infectious problem affecting the outer ear (pinna) that cannot be more specifically identified. It is used when the exact nature of the ear condition is not documented or determined. H61.199 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).

H61.199 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 only when the specific noninfective pinna disorder cannot be determined; always attempt to obtain more specific documentation from the provider before defaulting to this unspecified code.