2019 ICD-10-CM Diagnosis Code H66.4

Suppurative otitis media, unspecified

    2016 2017 2018 2019 Non-Billable/Non-Specific Code
  • H66.4 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2019 edition of ICD-10-CM H66.4 became effective on October 1, 2018.
  • This is the American ICD-10-CM version of H66.4 - other international versions of ICD-10 H66.4 may differ.
Applicable To
  • Purulent otitis media NOS
Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code for any associated perforated tympanic membrane (
    ICD-10-CM Diagnosis Code H72
    • H72 Perforation of tympanic membrane
      • H72.0 Central perforation of tympanic membrane
        • H72.00 Central perforation of tympanic membrane, uns...
        • H72.01 Central perforation of tympanic membrane, rig...
        • H72.02 Central perforation of tympanic membrane, lef...
        • H72.03 Central perforation of tympanic membrane, bil...
      • H72.1 Attic perforation of tympanic membrane
        • H72.10 Attic perforation of tympanic membrane, unspe...
        • H72.11 Attic perforation of tympanic membrane, right...
        • H72.12 Attic perforation of tympanic membrane, left ...
        • H72.13 Attic perforation of tympanic membrane, bilat...
      • H72.2 Other marginal perforations of tympanic membr...
        • H72.2X Other marginal perforations of tympanic membr...
          • H72.2X1 Other marginal perforations of tympanic membr...
          • H72.2X2 Other marginal perforations of tympanic membr...
          • H72.2X3 Other marginal perforations of tympanic membr...
          • H72.2X9 Other marginal perforations of tympanic membr...
      • H72.8 Other perforations of tympanic membrane
        • H72.81 Multiple perforations of tympanic membrane
          • H72.811 Multiple perforations of tympanic membrane, r...
          • H72.812 Multiple perforations of tympanic membrane, l...
          • H72.813 Multiple perforations of tympanic membrane, b...
          • H72.819 Multiple perforations of tympanic membrane, u...
        • H72.82 Total perforations of tympanic membrane
          • H72.821 Total perforations of tympanic membrane, righ...
          • H72.822 Total perforations of tympanic membrane, left...
          • H72.823 Total perforations of tympanic membrane, bila...
          • H72.829 Total perforations of tympanic membrane, unsp...
      • H72.9 Unspecified perforation of tympanic membrane
        • H72.90 Unspecified perforation of tympanic membrane,...
        • H72.91 Unspecified perforation of tympanic membrane,...
        • H72.92 Unspecified perforation of tympanic membrane,...
        • H72.93 Unspecified perforation of tympanic membrane,...
    H72.-
    )
The following code(s) above H66.4 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to H66.4:
  • H60-H95
    2019 ICD-10-CM Range H60-H95

    Diseases of the ear and mastoid process

    Note
    • Use an external cause code following the code for the ear condition, if applicable, to identify the cause of the ear condition
    Type 2 Excludes
    • 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)
    Diseases of the ear and mastoid process
  • H66
    ICD-10-CM Diagnosis Code H66

    Suppurative and unspecified otitis media

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Includes
    • suppurative and unspecified otitis media with myringitis
    Use Additional
    • code to identify:
    • exposure to environmental tobacco smoke (Z77.22)
    • exposure to tobacco smoke in the perinatal period (P96.81)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)
    Suppurative and unspecified otitis media
Clinical Information
  • Inflammation of the middle ear with purulent discharge.
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
Code annotations containing back-references to H66.4:
  • Code First: G05
    , H72
    ICD-10-CM Diagnosis Code G05

    Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code First
    • underlying disease, such as:
    • human immunodeficiency virus [HIV] disease (B20)
    • poliovirus (A80.-)
    • suppurative otitis media (H66.01-H66.4)
    • trichinellosis (B75)
    Type 1 Excludes
    • adenoviral encephalitis, myelitis and encephalomyelitis (A85.1)
    • congenital toxoplasmosis encephalitis, myelitis and encephalomyelitis (P37.1)
    • cytomegaloviral encephalitis, myelitis and encephalomyelitis (B25.8)
    • encephalitis, myelitis and encephalomyelitis (in) measles (B05.0)
    • encephalitis, myelitis and encephalomyelitis (in) systemic lupus erythematosus (M32.19)
    • enteroviral encephalitis, myelitis and encephalomyelitis (A85.0)
    • eosinophilic meningoencephalitis (B83.2)
    • herpesviral [herpes simplex] encephalitis, myelitis and encephalomyelitis (B00.4)
    • listerial encephalitis, myelitis and encephalomyelitis (A32.12)
    • meningococcal encephalitis, myelitis and encephalomyelitis (A39.81)
    • mumps encephalitis, myelitis and encephalomyelitis (B26.2)
    • postchickenpox encephalitis, myelitis and encephalomyelitis (B01.1-)
    • rubella encephalitis, myelitis and encephalomyelitis (B06.01)
    • toxoplasmosis encephalitis, myelitis and encephalomyelitis (B58.2)
    • zoster encephalitis, myelitis and encephalomyelitis (B02.0)
    ICD-10-CM Diagnosis Code H72

    Perforation of tympanic membrane

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code First
    Includes
    • persistent post-traumatic perforation of ear drum
    • postinflammatory perforation of ear drum
    Type 1 Excludes
    • acute suppurative otitis media with rupture of the tympanic membrane (H66.01-)
    • traumatic rupture of ear drum (S09.2-)

Diagnosis Index entries containing back-references to H66.4:
  • Otitis (acute) H66.90
    ICD-10-CM Diagnosis Code H66.90

    Otitis media, unspecified, unspecified ear

      2016 2017 2018 2019 Billable/Specific Code
    • media (hemorrhagic) (staphylococcal) (streptococcal) H66.9-
      ICD-10-CM Diagnosis Code H66.9-

      Otitis media, unspecified

        2016 2017 2018 2019 Non-Billable/Non-Specific Code
      Applicable To
      • Otitis media NOS
      • Acute otitis media NOS
      • Chronic otitis media NOS
      Use Additional
      • code for any associated perforated tympanic membrane (H72.-)

ICD-10-CM Codes Adjacent To H66.4
H66.20 …… unspecified ear
H66.21 …… right ear
H66.22 …… left ear
H66.23 …… bilateral
H66.3 Other chronic suppurative otitis media
H66.3X Other chronic suppurative otitis media
H66.3X1 …… right ear
H66.3X2 …… left ear
H66.3X3 …… bilateral
H66.3X9 …… unspecified ear
H66.4 Suppurative otitis media, unspecified
H66.40 …… unspecified ear
H66.41 …… right ear
H66.42 …… left ear
H66.43 …… bilateral
H66.9 Otitis media, unspecified
H66.90 …… unspecified ear
H66.91 …… right ear
H66.92 …… left ear
H66.93 …… bilateral
H67 Otitis media in diseases classified elsewhere

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.