Excludes1 pair
A04.4 vs A05-
A04.4 and A05 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on A05
Escherichia coli infection (A04.0-A04.4)
A04.4
Other intestinal Escherichia coli infections
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A00-A09
Use when the record says
- Escherichia coli enteritis NOS
Indexed under
- Diarrhea, diarrheal › due to › Escherichia coli
- Diarrhea, diarrheal › due to › Escherichia coli › enteroaggregative
- Diarrhea, diarrheal › due to › Escherichia coli › specified NEC
- Enteritis › infectious NOS › due to › Escherichia coli
- Enteritis › infectious NOS › due to › Escherichia coli › enteroaggregative
A05
Other bacterial foodborne intoxications, not elsewhere classified
Not billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A00-A09
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027