FY2027
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Excludes1 pair

A41- vs O85

A41 and O85 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
puerperal sepsis (O85)
A41

Other sepsis

Not billable
Chapter 1
Certain infectious and parasitic diseases
Section
A30-A49
O85

Puerperal sepsis

Billable
Chapter 15
Pregnancy, childbirth and the puerperium
Section
O85-O92
Use when the record says
  • Postpartum sepsis
  • Puerperal peritonitis
  • Puerperal pyemia
Indexed under
  • Pelviperitonitis › puerperal
  • Peritonitis › puerperal, postpartum, childbirth
  • Puerperal, puerperium › metroperitonitis
  • Puerperal, puerperium › parametritis
  • Puerperal, puerperium › pelviperitonitis

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