H70.099 — Acute mastoiditis with other complications, unspecified ear
Is H70.099 billable?
Yes, but H70.099 will trip a Medicare edit. H70.099 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H70.099 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.
H70.099 at a glance
| Code | H70.099 |
|---|---|
| Description | Acute mastoiditis with other complications, unspecified ear |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to H70.099?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H70.099 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 H70.099 group to?
H70.099 sits in MDC 03 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 152Otitis Media and URI with MCCmedical
- 153Otitis Media and URI without MCCmedical
As a secondary diagnosis, H70.099 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is H70.099 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under H70.09, the nearest indexed parent of H70.099. Use them to find the family, then select the specific code.
- Mastoiditis › acute, subacute › complicated NEC (coalescent) (hemorrhagic) (suppurative)
Excludes2 — not included here — inherited from Chapter 8
The conditions below are not part of H70.099, but a patient may have both at the same time. When documentation supports it, H70.099 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 H70.099 existed?
H70.099 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.