Is H65.196 a billable ICD-10-CM code?

Yes. H65.196 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H65.196 sit in the tabular list?

Diseases of the ear and mastoid process (H60-H95), in the block Diseases of middle ear and mastoid (H65-H75).

What cannot be coded together with H65.196?

H65.196 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H65.196 (H65.1) and apply to it just the same.

H65.196

H65.196 — Other acute nonsuppurative otitis media, recurrent, bilateral

Billable / specific codeICD-10-CMbilateral

H65.196 is a billable, specific ICD-10-CM code for other acute nonsuppurative otitis media, recurrent, bilateral. It is valid for submission on a claim.

Excludes1 inherited from the categories above H65.196

These are not written on H65.196, but they bind it: a note on a category applies to every code beneath it. Billing H65.196 with anything listed here is a denial.

Written on H65.1 — Other acute nonsuppurative otitis media

otitic barotrauma (T70.0)
otitis media (acute) NOS (H66.9)

Risk adjustment

H65.196 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

H65.196 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57181Billing and Coding: Allergy Testing
A57181Billing and Coding: Allergy Testing
A57434Billing and Coding: Vestibular and Audiologic Function Studies
A57434Billing and Coding: Vestibular and Audiologic Function Studies

Code history

H65.196 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H65.19. If H65.196 is not quite right, the correct code is usually one of these.

Questions about H65.196

Is H65.196 a billable ICD-10-CM code?: Yes. H65.196 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H65.196 sit in the tabular list?: Diseases of the ear and mastoid process (H60-H95), in the block Diseases of middle ear and mastoid (H65-H75).
What cannot be coded together with H65.196?: H65.196 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H65.196 (H65.1) and apply to it just the same.