FY2027
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Excludes1 pair

A41.4 vs A48.0

A41.4 and A48.0 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 A41.4
gas gangrene (A48.0)
A41.4

Sepsis due to anaerobes

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
A30-A49
Indexed under
  • Sepsis › anaerobic
  • Sepsis › Gram-negative › anaerobic
  • Infection, infected, infective › Clostridioides › difficile › sepsis
  • Infection, infected, infective › Clostridium NEC › difficile › sepsis
  • Infection, infected, infective › Clostridium NEC › perfringens › sepsis
A48.0

Gas gangrene

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
A30-A49
Use when the record says
  • Clostridial cellulitis
  • Clostridial myonecrosis
Indexed under
  • Aerogenes capsulatus infection
  • Myonecrosis, clostridial
  • Abscess › anerobic
  • Cellulitis › anaerobic
  • Cellulitis › clostridial

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