Excludes1 pair
A05.1 vs A48.5-
A05.1 and A48.5 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 A48.5
food poisoning due to toxins of Clostridium botulinum (A05.1)
A05.1
Botulism food poisoning
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A00-A09
Use when the record says
- Botulism NOS
- Classical foodborne intoxication due to Clostridium botulinum
Indexed under
- Botulism (foodborne intoxication)
- Poisoning › botulism
- Poisoning › Clostridium botulinum
- Enteritis › Clostridium › botulinum (food poisoning)
- Infection, infected, infective › Clostridium NEC › botulinum (food poisoning)
A48.5
Other specified botulism
Not billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A30-A49
Use when the record says
- Non-foodborne intoxication due to toxins of Clostridium botulinum [C. botulinum]
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