H65.3 vs H74.1
H65.3 and H74.1 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on H65.3
adhesive middle ear disease (H74.1)
H65.3
Chronic mucoid otitis media
Not billable
- Chapter 8
- Diseases of the ear and mastoid process
- Section
- H65-H75
Use when the record says
- Chronic mucinous otitis media
- Chronic secretory otitis media
- Chronic transudative otitis media
- Glue ear
Indexed under
- Otitis › media › nonsuppurative › chronic › mucoid (acute)
H74.1
Adhesive middle ear disease
Not billable
- Chapter 8
- Diseases of the ear and mastoid process
- Section
- H65-H75
Use when the record says
- Adhesive otitis
Indexed under
- Adhesions, adhesive › ear › middle (postinfective)
- Disorder › ear › middle › adhesive (of)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027