H65 vs H74.1
H65 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 H74.1
glue ear (H65.3-)
H65
Nonsuppurative otitis media
Not billable
- Chapter 8
- Diseases of the ear and mastoid process
- Section
- H65-H75
Use when the record says
- nonsuppurative otitis media with myringitis
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