Is H74.12 a billable ICD-10-CM code?

Yes. H74.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H74.12 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 H74.12?

H74.12 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 H74.12 (H74.1) and apply to it just the same.

H74.12

H74.12 — Adhesive left middle ear disease

Billable / specific codeICD-10-CMleft

H74.12 is a billable, specific ICD-10-CM code for adhesive left middle ear disease. It is valid for submission on a claim.

Excludes1 inherited from the categories above H74.12

These are not written on H74.12, but they bind it: a note on a category applies to every code beneath it. Billing H74.12 with anything listed here is a denial.

Written on H74.1 — Adhesive middle ear disease

glue ear (H65.3-)

Excludes2 inherited from the categories above H74.12

Also inherited, and the opposite of Excludes1: these conditions are not part of H74.12, but a patient can have both, so you may code both.

Written on H74 — Other disorders of middle ear mastoid

mastoiditis (H70.-)

Risk adjustment

H74.12 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

H74.12 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

Code history

H74.12 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 H74.1. If H74.12 is not quite right, the correct code is usually one of these.

Questions about H74.12

Is H74.12 a billable ICD-10-CM code?: Yes. H74.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H74.12 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 H74.12?: H74.12 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 H74.12 (H74.1) and apply to it just the same.