ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 H65.116

Billable / Specific

Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, bilateral

H65
Block
0
Synonyms
171
LCDs
8
Payer Policies
0
Linked CPTs

About ICD-10-CM H65.116

ICD-10-CM code H65.116 represents Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, bilateral. This is a billable/specific code in the Ear and Mastoid Process chapter (block H65). The 2026 edition of ICD-10-CM H65.116 became effective on October 1, 2025.

Medicare LCD Coverage for H65.116

Local Coverage Determinations (LCDs) from CMS MACs that list H65.116 as a covered diagnosis.

171 LCDs

Showing top 10 of 171 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95056 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95004 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95027 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 82785 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95076 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95024 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95070 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95028 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 95017 →
CMS LCD: Billing and Coding: Allergy Diagnostic Testing
Article ID: 60390, Effective: , 814 covered, 0 non-covered
CPT 86003 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H65.116.

8 policies

5 Medicare

Billing and Coding: Allergy Testing
Policy ID: ART-57181
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Vestibular and Audiologic Function Studies
Policy ID: ART-57434
Billing and Coding: Allergy Diagnostic Testing
Policy ID: ART-60360
Billing and Coding: Allergy Diagnostic Testing
Policy ID: ART-60363

CPT Codes Commonly Billed with H65.116

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for H65.116

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert H65.116 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
H65.116 38102 10000
H65.116 38103 10000
H65.116 38104 10000
H65.116 38105 10000
H65.116 38106 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 H65.116, Billing FAQ

Is ICD-10 code H65.116 billable? +

Yes, H65.116 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does H65.116 map to? +

Per CMS GEMs, H65.116 maps to ICD-9 codes: 38102, 38103, 38104, 38105, 38106. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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