H67 ICD-10-CM Code: Otitis media in diseases classified elsewhere
H67 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC 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)
H67
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOtitis media in diseases classified elsewhere
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 H67. 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
OfficialNo Includes notes are included in this display for H67. Check the code and parent instructions in the Code Book.
Excludes 1
Official- otitis media in:
- influenza (J09.X9, J10.83, J11.83)
- measles (B05.3)
- scarlet fever (A38.0)
- tuberculosis (A18.6)
Code First
Official- underlying disease, such as:
- plasminogen deficiency (E88.02)
- viral disease NEC (B00-B34)
Use Additional
Official- code for any associated perforated tympanic membrane (H72.-)
Code Also
OfficialNo Code Also instructions are included in this display for H67. 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
- H67
- Description
- Otitis media in diseases classified elsewhere
- 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
H67 is the ICD-10-CM diagnosis code for otitis media in diseases classified elsewhere. H67 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 H67 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 H67 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1, Do NOT code together
Use Additional Code
- code for any associated perforated tympanic membrane (H72.-)