Excludes1 pair

A15- vs J64

A15 and J64 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 J64
pneumonoconiosis with tuberculosis, any type in A15 (J65)
A15

Respiratory tuberculosis

Not billable
Chapter 1
Certain infectious and parasitic diseases
Section
A15-A19
J64

Unspecified pneumoconiosis

BillableUnspecified
Chapter 10
Diseases of the respiratory system
Section
J60-J70
Indexed under
  • Pneumoconiosis (due to) (inhalation of)
  • Asthma, asthmatic › pneumoconiotic NEC
  • Fibrosis, fibrotic › lung › with › dust reticulation
  • Fibrosis, fibrotic › lung › with › pneumoconiosis NOS

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