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H66.013

Billable

Acute suppurative otitis media with spontaneous rupture of ear drum, bilateral

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

What This Code Means

This is a serious ear infection affecting both ears where pus builds up and causes the eardrum to burst on its own. The infection develops suddenly and requires prompt medical attention.

Coding Tips

  • Verify documentation confirms bilateral (both ears) involvement and spontaneous rupture before assigning this code; if only one ear is affected, use H66.011 instead
  • Ensure the medical record explicitly states 'acute' and 'suppurative' (pus-forming) characteristics; this code requires confirmation of both the infection type and the spontaneous rupture of the tympanum

Code Hierarchy

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