FY 2027 MEDESUN®
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Section I.C.8 · H60-H95 · FY 2027

Chapter 8 — Diseases of the Ear and Mastoid Process

Reserved for future guideline expansion — laterality, acute-versus-chronic, combination codes and the Tabular List notes carry the chapter.

Dr. Santosh Kumar Guptha, CCS, CPC, COC, CIC, CRC, CPMA, CDIP, CPCO — AHIMA-Approved ICD-10-CM/PCS Trainer, MEDESUN® Medical Coding Academy Guidelines effective October 1, 2026 – September 30, 2027

The FY 2027 guidelines carry no chapter-specific guidelines for Chapter 8 (H60-H95). The entry reads: reserved for future guideline expansion. That is not a gap you may fill with judgement — it means the conventions in Section I.A, the general guidelines in Section I.B, the instructional notes in the Tabular List, and Sections II, III and IV carry the whole weight of coding this chapter.

General rules that do the work in Chapter 8#

General guidelineWhy it matters here
I.B.13 LateralityRight, left and bilateral are built into most ear codes. Where the condition is bilateral and no bilateral code exists, assign codes for both sides. The unspecified-ear code should rarely be used.
I.B.12 Same code onceA bilateral condition with no bilateral code cannot be reported by listing the unilateral code twice. Each unique code is reported only once per encounter — you assign the right code and the left code.
I.B.8 Acute and chronicWhere both are documented and separate Index subentries exist at the same indentation level, code both with the acute first — unless a combination code exists, in which case I.B.9 requires the combination code alone.
I.A.12 Excludes notesThe ear chapter carries a dense set of Excludes1 and Excludes2 notes, particularly between congenital and acquired deformities and between otitis media subtypes. Read them in the Tabular List.
I.C.1.b Organism codesWhere an ear infection code does not identify the organism, a code from B95, B96 or B97 is assigned as an additional code when an instructional note so directs.
I.C.19 ComplicationsIntraoperative and postprocedural complications of the ear and mastoid are found within this body-system chapter, and Section I.C.19.g.5 directs that body-system complication codes are sequenced first, followed by a code for the specific complication.

Practice questions#

Q1What do the FY 2027 guidelines provide for Chapter 8?

  1. AGuidelines on hearing loss laterality
  2. B“Reserved for future guideline expansion”
  3. CA cross-reference to Chapter 7
  4. DGuidelines on cochlear implant complications
Show answer & rationale

Correct answer: B. “Reserved for future guideline expansion”

Rationale. The FY 2027 guidelines list Chapter 8, diseases of the ear and mastoid process (H60-H95), as reserved for future guideline expansion. Chapters 3 and 11 carry the same entry. Coding in this chapter is driven entirely by the conventions, the general guidelines and the Tabular List instructional notes.

Q2A patient has a bilateral condition of the ear for which the classification provides no bilateral code. How is it reported?

  1. AThe unilateral code reported twice
  2. BSeparate codes for the right side and the left side
  3. CThe unspecified-ear code
  4. DOne unilateral code only
Show answer & rationale

Correct answer: B. Separate codes for the right side and the left side

Rationale. Section I.B.13 states that if no bilateral code is provided and the condition is bilateral, separate codes for both the left and right side are assigned. Section I.B.12 forecloses the alternative: each unique ICD-10-CM diagnosis code may be reported only once for an encounter, which the guideline applies specifically to bilateral conditions where there are no distinct codes identifying laterality.

Q3Both acute and chronic forms of the same ear condition are documented, and a combination code exists in the classification that identifies both. What is assigned?

  1. ABoth the acute and chronic codes, acute first
  2. BThe combination code alone
  3. CThe chronic code only
  4. DThe combination code plus the acute code
Show answer & rationale

Correct answer: B. The combination code alone

Rationale. Section I.B.9 states that only the combination code is assigned when that code fully identifies the diagnostic conditions involved or when the Alphabetic Index so directs, and that multiple coding should not be used where the classification provides a combination code that clearly identifies all of the elements documented. Section I.B.8, which would direct two codes with the acute sequenced first, applies only where separate subentries exist at the same indentation level and no combination code covers the picture.

Q4An ear infection code does not identify the causal organism, and the Tabular List carries a note directing an additional organism code. Where does that code come from?

  1. AChapter 18
  2. BChapter 1, categories B95, B96 or B97
  3. CChapter 21
  4. DChapter 22
Show answer & rationale

Correct answer: B. Chapter 1, categories B95, B96 or B97

Rationale. Section I.C.1.b states that certain infections are classified in chapters other than Chapter 1 with no organism identified as part of the infection code, and that in those instances it is necessary to use an additional code from Chapter 1 — B95 for streptococcus, staphylococcus and enterococcus, B96 for other bacterial agents, or B97 for viral agents. Section I.B.7 describes the same mechanism as multiple coding for a single condition.

Q5A postprocedural complication of the mastoid occurs. Where is the complication code found, and how is it sequenced?

  1. AChapter 19 only, sequenced first
  2. BWithin Chapter 8, sequenced first, followed by a code for the specific complication
  3. CChapter 21, sequenced second
  4. DEither chapter, at the coder's discretion
Show answer & rationale

Correct answer: B. Within Chapter 8, sequenced first, followed by a code for the specific complication

Rationale. Section I.C.19.g.5 states that intraoperative and postprocedural complication codes are found within the body system chapters with codes specific to the organs and structures of that body system, that these codes should be sequenced first followed by a code for the specific complication if applicable, and that body-system complication codes should be assigned unless the complication is specifically indexed to a T code in Chapter 19.

Scenarios#

Scenario 1Bilateral hearing loss of different types

An audiology record documents sensorineural hearing loss of the right ear and conductive hearing loss of the left ear.

Show coded answer & rationale
SeqCodeDescription
11the code for sensorineural hearing loss, right ear
22the code for conductive hearing loss, left ear

Rationale. There is no chapter-specific guideline, so Section I.B.13 laterality governs together with the code structure in the Tabular List. Two distinct conditions affecting different ears are reported with the two specific unilateral codes; a bilateral code would misstate the clinical picture because the two ears have different diagnoses. Verify each code in the Tabular List rather than assuming the Index entry is complete.

Guideline: Section I.B.1, I.B.13

Scenario 2An Excludes1 between a congenital and an acquired deformity

A record documents an acquired deformity of the pinna following trauma. The Tabular List shows an Excludes1 note at the acquired code naming the congenital malformation code.

Show coded answer & rationale
SeqCodeDescription
11the acquired deformity code only

Rationale. Convention I.A.12.a explains this pairing directly: an Excludes1 note is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Only one of the two codes may be assigned. The unrelated-conditions exception has no application here, because a single deformity is either congenital or acquired.

Guideline: Section I.A.12.a

Primary sources#