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H65 ICD-10-CM Code: Nonsuppurative otitis media

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FY 2026 Apr update / Diseases of the ear and mastoid process (H60-H95) / Diseases of middle ear and mastoid (H65-H75)

H65

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Nonsuppurative otitis media

Nonsuppurative otitis media

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H6Diseases of middle ear and mastoid (H65-H75)
H65Nonsuppurative otitis media

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H65 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H65 in this effective period.

Related Child Codes

Official
H65.0Acute serous otitis media
H65.1Other acute nonsuppurative otitis media
H65.2Chronic serous otitis media
H65.3Chronic mucoid otitis media
H65.4Other chronic nonsuppurative otitis media

Includes

Official
  • nonsuppurative otitis media with myringitis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H65 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H65 in this effective period.

Use Additional

Official
  • code for any associated perforated tympanic membrane (H72.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for H65 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

H65 is the ICD-10-CM diagnosis code for nonsuppurative otitis media. H65 sits in the ICD-10-CM chapter for diseases of the ear and mastoid process (h60-h95), within the section covering diseases of middle ear and mastoid (h65-h75).

Header codes like H65 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 H65'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 H65 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • nonsuppurative otitis media with myringitis

Use Additional Code

  • code for any associated perforated tympanic membrane (H72.-)

Child Codes

Code Hierarchy

H65Nonsuppurative otitis media
H65Nonsuppurative otitis media

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