A05.1 vs A48.5
A05.1 and A48.5 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 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 (acute)
- Poisoning › Clostridium botulinum (acute)
- Enteritis › Clostridium › botulinum (acute) (diarrheal) (hemorrhagic) (noninfective)
- Infection, infected, infective › Clostridium NEC › botulinum (opportunistic)
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