Excludes1 pair
H65.3- vs H74.1-
H65.3 and H74.1 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
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
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
- Disorder › ear › middle › adhesive
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