A04.4 vs A05
A04.4 and A05 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
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 (disease) (infantile) (inflammatory)
- Diarrhea, diarrheal › due to › Escherichia coli › enteroaggregative (disease) (infantile) (inflammatory)
- Diarrhea, diarrheal › due to › Escherichia coli › specified NEC (disease) (infantile) (inflammatory)
- Enteritis › infectious NOS › due to › Escherichia coli (acute) (diarrheal) (hemorrhagic) (noninfective)
- Enteritis › infectious NOS › due to › Escherichia coli › enteroaggregative (acute) (diarrheal) (hemorrhagic) (noninfective)
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