H61.321 ICD-10-CM Code: Acquired stenosis of right external ear canal secondary to inflammation and infection

H61.321 is the ICD-10-CM diagnosis code for acquired stenosis of right external ear canal secondary to inflammation and infection. The right ear canal has become narrowed or blocked as a result of inflammation and infection that has caused scarring or swelling. This condition develops over time due to repeated or chronic ear infections rather than being present from birth. H61.321 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).

H61.321 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 documentation specifies the right ear and confirms the stenosis is secondary to inflammation/infection; do not use this code if the cause is trauma, surgery, or other etiology.