A15.4 vs A15.7
A15.4 and A15.7 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 A15.4
tuberculosis specified as primary (A15.7)
A15.4
Tuberculosis of intrathoracic lymph nodes
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A15-A19
Use when the record says
- Tuberculosis of hilar lymph nodes
- Tuberculosis of mediastinal lymph nodes
- Tuberculosis of tracheobronchial lymph nodes
Indexed under
- Tuberculosis, tubercular, tuberculous › hilar lymph nodes (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
- Tuberculosis, tubercular, tuberculous › mediastinal lymph gland or node (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
- Adenopathy › tracheobronchial › tuberculous (lymph gland)
- Adenopathy › tuberculous › tracheobronchial (lymph gland)
- Tuberculosis, tubercular, tuberculous › bronchi, bronchial, bronchus › gland or node (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
A15.7
Primary respiratory tuberculosis
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A15-A19
Indexed under
- Epituberculosis (with atelectasis) (allergic)
- Ghon tubercle, primary infection
- Complex › primary, tuberculous
- Infection, infected, infective › Ghon tubercle, primary (opportunistic)
- Tubercle › Ghon, primary infection
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