Excludes1 pair

A09 vs K52.9

A09 and K52.9 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 distinction is infectious vs non-infective origin.

The official note, declared on A09
colitis NOS (K52.9)
A09

Infectious gastroenteritis and colitis, unspecified

BillableUnspecified
Chapter 1
Certain infectious and parasitic diseases
Section
A00-A09
Use when the record says
  • Infectious colitis NOS
  • Infectious enteritis NOS
  • Infectious gastroenteritis NOS
Indexed under
  • Dysentery, dysenteric (catarrhal) (diarrhea) (epidemic) (hemorrhagic) (infectious) (sporadic) (tropical)
  • Diarrhea, diarrheal › dysenteric
  • Diarrhea, diarrheal › endemic
  • Diarrhea, diarrheal › epidemic
  • Diarrhea, diarrheal › infectious
K52.9

Noninfective gastroenteritis and colitis, unspecified

BillableUnspecified
Chapter 11
Diseases of the digestive system
Section
K50-K52
Use when the record says
  • Colitis NOS
  • Enteritis NOS
  • Gastroenteritis NOS
  • Ileitis NOS
  • Jejunitis NOS
  • Sigmoiditis NOS
Indexed under
  • Cecitis
  • Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic)
  • Enteritis (acute) (diarrheal) (hemorrhagic) (noninfective)
  • Enterocolitis
  • Gastroenteritis (acute) (chronic) (noninfectious)

These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.

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