What is ICD-10 code H62.42?

H62.42 is the ICD-10-CM diagnosis code for Otitis externa in other diseases classified elsewhere, left ear. An infection or inflammation of the left external ear that occurs as a complication of another disease. H62.42 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H62.42 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H62.42 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H62.42 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does H62.42 map to under V28?

H62.42 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H62.42?

H62.42 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H62.42?

H62.42 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports H62.42?

Verify laterality is documented as left before assigning this code Always identify and code the primary underlying condition that caused the otitis externa H62.42 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM H62.42: Otitis externa in other diseases

H62.42 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupH62.42

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the ear and mastoid process (H60-H95) / Diseases of external ear (H60-H62)

H62.42

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Otitis externa in other diseases classified elsewhere, left ear

An infection or inflammation of the left external ear that occurs as a complication of another disease.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H62Disorders of external ear in diseases classified elsewhere H62.4Otitis externa in other diseases classified elsewhere H62.42Otitis externa in other diseases classified elsewhere, left ear

Inclusion Terms

Official

No inclusion terms are included in this display for H62.42. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H60-H95
certain infectious and parasitic diseases (A00-B99)Inherited from H60-H95
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H60-H95
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from H60-H95
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H60-H95
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H60-H95
neoplasms (C00-D49)Inherited from H60-H95
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H60-H95

Related Codes

Official

H62.40Otitis externa in other diseases classified elsewhere, unspecified ear H62.41Otitis externa in other diseases classified elsewhere, right ear H62.43Otitis externa in other diseases classified elsewhere, bilateral

Includes

Official

No Includes notes are included in this display for H62.42. Check the code and parent instructions in the Code Book.

Excludes 1

Official

otitis externa (in):Inherited from H62.4
candidiasis (B37.84)Inherited from H62.4
herpes viral [herpes simplex] (B00.1)Inherited from H62.4
herpes zoster (B02.8)Inherited from H62.4

Code First

Official

underlying disease, such as:Inherited from H62.4
erysipelas (A46)Inherited from H62.4
impetigo (L01.0-)Inherited from H62.4

Use Additional

Official

No Use Additional Code instructions are included in this display for H62.42. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H62.42. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify laterality is documented as left before assigning this code

Always identify and code the primary underlying condition that caused the otitis externa

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is H62.42 an HCC code?

No. H62.42 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H62.42
Description: Otitis externa in other diseases classified elsewhere, left ear
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

H62.42 is the ICD-10-CM diagnosis code for otitis externa in other diseases classified elsewhere, left ear. An infection or inflammation of the left external ear that occurs as a complication of another disease. H62.42 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).

H62.42 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify laterality is documented as left before assigning this code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H62.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify laterality is documented as left before assigning this code
•Always identify and code the primary underlying condition that caused the otitis externa