Is H72.2X3 a billable ICD-10-CM code?

Yes. H72.2X3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H72.2X3 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 H72.2X3?

H72.2X3 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 H72.2X3 (H72) and apply to it just the same.

H72.2X3

H72.2X3 — Other marginal perforations of tympanic membrane, bilateral

Billable / specific codeICD-10-CMbilateral

H72.2X3 is a billable, specific ICD-10-CM code for other marginal perforations of tympanic membrane, bilateral. It is valid for submission on a claim.

Excludes1 inherited from the categories above H72.2X3

These are not written on H72.2X3, but they bind it: a note on a category applies to every code beneath it. Billing H72.2X3 with anything listed here is a denial.

Written on H72 — Perforation of tympanic membrane

acute suppurative otitis media with rupture of the tympanic membrane (H66.01-)
traumatic rupture of ear drum (S09.2-)

Risk adjustment

H72.2X3 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

H72.2X3 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A57204Billing and Coding: MRI and CT Scans of the Head and Neck
A57434Billing and Coding: Vestibular and Audiologic Function Studies

Code history

H72.2X3 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 H72.2X. If H72.2X3 is not quite right, the correct code is usually one of these.

Questions about H72.2X3

Is H72.2X3 a billable ICD-10-CM code?: Yes. H72.2X3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H72.2X3 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 H72.2X3?: H72.2X3 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 H72.2X3 (H72) and apply to it just the same.