H60.23 Malignant otitis externa, bilateral

ICD-10-CM Diagnosis Code H60.23: Malignant otitis externa, bilateral

ICD-10-CM code H60.23 represents malignant otitis externa affecting both ears. Clinical literature describes this condition as a severe, life-threatening infection of the external auditory canal and skull base that is not cancerous. The condition is also known as necrotizing otitis externa and occurs most frequently in immunocompromised patients and older patients with diabetes mellitus. 1 2 4

Plain-language overview

Malignant otitis externa is a severe infection that affects the external auditory canal, skull base, and temporal bone. The condition is not cancerous, but it can rapidly spread in a patient's body and has been historically associated with a high mortality rate. 1

Malignant or necrotizing otitis externa is a life-threatening condition that occurs most commonly in immunocompromised patients and older patients with diabetes mellitus. It is identified as a complication of otitis externa. 2

What this code represents

The ICD-10-CM code H60.23 represents the diagnosis of malignant otitis externa, bilateral. The code specifically designates that the condition is present in both ears. 4

Coding details

The ICD-10-CM code H60.21 represents malignant otitis externa of the right ear, distinguishing it from the bilateral presentation designated by H60.23. The code H60.20 represents malignant otitis externa of an unspecified ear. 4 5

Documentation considerations

Otitis externa is a clinical diagnosis that requires a complete history and physical examination. Otorhinolaryngology is consulted for severe cases presenting with complete occlusion of the external ear canal or when necrotizing otitis externa is suspected. 2

What the sources add

Clinical literature from the National Center for Biotechnology Information describes malignant otitis externa as a severe infection, while the National Cancer Institute's EVS Explore resource provides the official ICD-10-CM code label and numerical designation for the bilateral condition. 1 4

The American Speech-Language-Hearing Association lists H60.20 for malignant otitis externa of an unspecified ear, while Unbound Medicine lists H60.23 for malignant otitis externa, bilateral. Both sources provide distinct code listings within the H60-H62 range for diseases of the external ear. 5 6

Clinical context

In recent times, malignant otitis externa has come to be known as necrotizing otitis externa. This term more accurately and distinctly characterizes the aggressive and pathological nature of the condition. 1

Sources

1. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
2. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
3. Phecode 380.1 · ExPRSweb — csg.sph.umich.edu; accessed 2026-07-25.
4. EVS Explore — evsexplore.semantics.cancer.gov; accessed 2026-07-25.
5. 2026 ICD-10-CM Diagnosis Codes Related to Hearing and ... — asha.org; accessed 2026-07-25.
6. H60.23 - Malignant otitis externa, bilateral | ICD-10-CM — unboundmedicine.com; accessed 2026-07-25.