Is H67.1 a billable ICD-10-CM code?

Yes. H67.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H67.1 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 H67.1?

H67.1 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 H67.1 (H67) and apply to it just the same.

H67.1

H67.1 — Otitis media in diseases classified elsewhere, right ear

Billable / specific codeICD-10-CMright

H67.1 is a billable, specific ICD-10-CM code for otitis media in diseases classified elsewhere, right ear. It is valid for submission on a claim.

Excludes1 inherited from the categories above H67.1

These are not written on H67.1, but they bind it: a note on a category applies to every code beneath it. Billing H67.1 with anything listed here is a denial.

Written on H67 — Otitis media in diseases classified elsewhere

otitis media in:
influenza (J09.X9, J10.83, J11.83)
measles (B05.3)
scarlet fever (A38.0)
tuberculosis (A18.6)

Risk adjustment

H67.1 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

H67.1 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57434Billing and Coding: Vestibular and Audiologic Function Studies
A57434Billing and Coding: Vestibular and Audiologic Function Studies

Code history

H67.1 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 H67. If H67.1 is not quite right, the correct code is usually one of these.

Questions about H67.1

Is H67.1 a billable ICD-10-CM code?: Yes. H67.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H67.1 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 H67.1?: H67.1 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 H67.1 (H67) and apply to it just the same.