ICD-10 · PDGM grouping
H72 Perforation of tympanic membrane
All 24 codes in the H72 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
24
Can lead a claim
18
Cannot lead a claim
6
What CMS assigns to H72
18 of the 24 codes group to MMTA - Other; 6 are assigned no clinical group. None of the 24 is assigned a comorbidity subgroup. 18 of the 24 can lead a claim. CMS attaches a code-first note to all 24.
Code first
CMS grouper convention 57, on all 24 codes. Code first:
- any associated otitis media (H65.-, H66.1-, H66.2-, H66.3-, H66.4-, H66.9-, H67.-)
Every code in H72
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| H72.0 Central perforation of tympanic membrane | ||||
| H72.00 | Central perforation of tympanic membrane, unspecified ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.01 | Central perforation of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.02 | Central perforation of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.03 | Central perforation of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
| H72.1 Attic perforation of tympanic membrane | ||||
| H72.10 | Attic perforation of tympanic membrane, unspecified ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.11 | Attic perforation of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.12 | Attic perforation of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.13 | Attic perforation of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
| H72.2 Other marginal perforations of tympanic membrane | ||||
| H72.2X Other marginal perforations of tympanic membrane | ||||
| H72.2X1 | Other marginal perforations of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.2X2 | Other marginal perforations of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.2X3 | Other marginal perforations of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
| H72.2X9 | Other marginal perforations of tympanic membrane, unspecified earCMS: Other marginal perforations of tympanic membrane, unsp ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.8 Other perforations of tympanic membrane | ||||
| H72.81 Multiple perforations of tympanic membrane | ||||
| H72.811 | Multiple perforations of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.812 | Multiple perforations of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.813 | Multiple perforations of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
| H72.819 | Multiple perforations of tympanic membrane, unspecified ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.82 Total perforations of tympanic membrane | ||||
| H72.821 | Total perforations of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.822 | Total perforations of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.823 | Total perforations of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
| H72.829 | Total perforations of tympanic membrane, unspecified ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.9 Unspecified perforation of tympanic membrane | ||||
| H72.90 | Unspecified perforation of tympanic membrane, unspecified earCMS: Unsp perforation of tympanic membrane, unspecified ear | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H72.91 | Unspecified perforation of tympanic membrane, right ear | Can lead a claim, code first applies | A | None |
| H72.92 | Unspecified perforation of tympanic membrane, left ear | Can lead a claim, code first applies | A | None |
| H72.93 | Unspecified perforation of tympanic membrane, bilateral | Can lead a claim, code first applies | A | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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