H65 ICD-10-CM Code: Nonsuppurative otitis media
H65 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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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 guidanceNonsuppurative otitis media
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for H65. 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
Includes
Official- nonsuppurative otitis media with myringitis
Excludes 1
OfficialNo Excludes 1 notes are included in this display for H65. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for H65. Check the code and parent instructions in the Code Book.
Use Additional
Official- code for any associated perforated tympanic membrane (H72.-)
- code, if applicable, to identify:
- exposure to environmental tobacco smoke (Z77.22)
- exposure to tobacco smoke in the perinatal period (P96.81)
- history of tobacco dependence (Z87.891)
- infectious agent (B95-B97)
- occupational exposure to environmental tobacco smoke (Z57.31)
- tobacco dependence (F17.-)
- tobacco use (Z72.0)
Code Also
OfficialNo Code Also instructions are included in this display for H65. Check the code and parent instructions in the Code Book.
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 →
- Code
- H65
- Description
- Nonsuppurative otitis media
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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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. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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.-)
- code, if applicable, to identify:
- exposure to environmental tobacco smoke (Z77.22)
- exposure to tobacco smoke in the perinatal period (P96.81)
- history of tobacco dependence (Z87.891)
- infectious agent (B95-B97)
- occupational exposure to environmental tobacco smoke (Z57.31)
- tobacco dependence (F17.-)
- tobacco use (Z72.0)