FY2027
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Excludes1 pair

A15.6 vs J90

A15.6 and J90 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 J90
tuberculous pleural effusion (A15.6)
A15.6

Tuberculous pleurisy

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
A15-A19
Use when the record says
  • Tuberculosis of pleura Tuberculous empyema
Indexed under
  • Empyema › tuberculous
  • Hemothorax › tuberculous NEC
  • Hydropneumothorax › tuberculous NEC
  • Hydrothorax › tuberculous NEC (non primary)
  • Pleurisy › tuberculous (with effusion) (non primary)
J90

Pleural effusion, not elsewhere classified

BillableUnspecified
Chapter 10
Diseases of the respiratory system
Section
J90-J94
Use when the record says
  • Encysted pleurisy
  • Pleural effusion NOS
  • Pleurisy with effusion (exudative) (serous)
Indexed under
  • Effusion › pleura, pleurisy, pleuritic, pleuropericardial
  • Pleurisy › pneumococcal
  • Pleurisy › streptococcal
  • Pleurisy › with › effusion

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