ICD-10 Code H65.4 – Other chronic nonsuppurative otitis media (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H65.4 – Other chronic nonsuppurative otitis media
What it is
H65.4 identifies chronic inflammation of the middle ear without pus. Use it when documentation describes a persistent, noninfected, or nonpurulent otitis media that does not fit a more specific subtype.
Clinical signs
Typical findings may include ear fullness, hearing reduction, or a history of recurrent middle ear disease. Clinical features vary; refer to documentation, especially when the note distinguishes chronic effusion from active suppurative infection.
When to use this code
Use H65.4 when the provider documents chronic nonsuppurative otitis media, chronic serous otitis media, or another chronic middle ear condition without pus and without a better specified code. It is appropriate for ongoing cases noted on exam, assessment, or problem lists. Check documentation if the record suggests acute infection, perforation, or another chronic ear diagnosis.
Do not use for
Do not use this code for acute otitis media, suppurative otitis media, or chronic otitis media with a perforated tympanic membrane. If the documentation names a different otitis media subtype, code that condition instead.
Coding tip
Confirm whether the provider documented nonsuppurative disease, because the presence of pus changes the code selection.