A18.7 vs E27.1
A18.7 and E27.1 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 E27.1
tuberculous Addison's disease (A18.7)
A18.7
Tuberculosis of adrenal glands
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A15-A19
Use when the record says
- Tuberculous Addison's disease
Indexed under
- Adrenalism, tuberculous
- Hypoadrenalism, hypoadrenia › tuberculous
- Tuberculosis, tubercular, tuberculous › Addison's disease (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
- Tuberculosis, tubercular, tuberculous › adrenal (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
- Tuberculosis, tubercular, tuberculous › bronze disease (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
E27.1
Primary adrenocortical insufficiency
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
Use when the record says
- Addison's disease
- Autoimmune adrenalitis
Indexed under
- Addison's › diseaseor syndrome
- Adrenalitis, adrenitis › autoimmune
- Disease, diseased › bronze Addison's
- Hypoadrenalism, hypoadrenia › primary
- Hypoadrenocorticism › primary
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