H60.20 — Malignant otitis externa, unspecified ear
Is H60.20 billable?
Yes, but H60.20 will trip a Medicare edit. H60.20 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H60.20 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
H60.20 at a glance
| Code | H60.20 |
|---|---|
| Description | Malignant otitis externa, unspecified ear |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to H60.20?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H60.20 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does H60.20 group to?
H60.20 sits in MDC 03 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 154Other Ear, Nose, Mouth and Throat Diagnoses with MCCmedical
- 155Other Ear, Nose, Mouth and Throat Diagnoses with CCmedical
- 156Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCCmedical
As a secondary diagnosis, H60.20 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is H60.20 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under H60.2, the nearest indexed parent of H60.20. Use them to find the family, then select the specific code.
- Otitis › externa › malignant (acute)
Excludes2 — not included here — inherited from Chapter 8
The conditions below are not part of H60.20, but a patient may have both at the same time. When documentation supports it, H60.20 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
How long has H60.20 existed?
H60.20 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.