H90.42 — Sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
H90.42 is a billable, specific ICD-10-CM code for sensorineural hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side. It is valid for submission on a claim.
Excludes1 inherited from the categories above H90.42
These are not written on H90.42, but they bind it: a note on a category applies to every code beneath it. Billing H90.42 with anything listed here is a denial.
Other codes that can never be billed with H90.42
These codes carry an Excludes1 note pointing at H90.42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading H90.42 alone.
Risk adjustment
H90.42 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
H90.42 is named in 19 Medicare coverage policies — 19 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52866Billing and Coding: Speech-Language Pathology
- A53052Billing and Coding: Home Health Speech-Language Pathology
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56497Billing and Coding: Vestibular Function Testing
Code history
H90.42 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 H90.4. If H90.42 is not quite right, the correct code is usually one of these.
Questions about H90.42
- Is H90.42 a billable ICD-10-CM code?
- Yes. H90.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H90.42 sit in the tabular list?
- Diseases of the ear and mastoid process (H60-H95), in the block Other disorders of ear (H90-H94).
- What cannot be coded together with H90.42?
- H90.42 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 H90.42 (H90) and apply to it just the same.