H72 ICD-10-CM Code: Perforation of tympanic membrane
H72 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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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)
H72
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidancePerforation of tympanic membrane
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 H72. 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- persistent post-traumatic perforation of ear drum
- postinflammatory perforation of ear drum
Excludes 1
Official- acute suppurative otitis media with rupture of the tympanic membrane (H66.01-)
- traumatic rupture of ear drum (S09.2-)
Code First
Official- any associated otitis media (H65.-, H66.1-, H66.2-, H66.3-, H66.4-, H66.9-, H67.-)
Use Additional
OfficialNo Use Additional Code instructions are included in this display for H72. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for H72. 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
- H72
- Description
- Perforation of tympanic membrane
- 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
H72 is the ICD-10-CM diagnosis code for perforation of tympanic membrane. H72 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 H72 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 H72 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- persistent post-traumatic perforation of ear drum
- postinflammatory perforation of ear drum