ICD-10 H66.019
Billable / SpecificAcute suppurative otitis media with spontaneous rupture of ear drum, unspecified ear
About ICD-10-CM H66.019
ICD-10-CM code H66.019 represents Acute suppurative otitis media with spontaneous rupture of ear drum, unspecified ear. This is a billable/specific code in the Ear and Mastoid Process chapter (block H66). The 2026 edition of ICD-10-CM H66.019 became effective on October 1, 2025.
Medicare LCD Coverage for H66.019
Local Coverage Determinations (LCDs) from CMS MACs that list H66.019 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H66.019.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H66.019 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H66.019
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 H66.019 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| H66.019 | 38201 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H66.019
Other codes in section H65-H75 (Diseases of middle ear and mastoid).
ICD-10 H66.019, Billing FAQ
Is ICD-10 code H66.019 billable? +
Yes, H66.019 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does H66.019 map to? +
Per CMS GEMs, H66.019 maps to ICD-9 codes: 38201. 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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