FY2027
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Excludes1 pair

A54.0- vs A54.1

A54.0 and A54.1 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 distinction is with vs without an associated condition.

The official note, declared on A54.0
gonococcal infection with genitourinary gland abscess (A54.1)
A54.0

Gonococcal infection of lower genitourinary tract without periurethral or accessory gland abscess

Not billable
Chapter 1
Certain infectious and parasitic diseases
Section
A50-A64
A54.1

Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
A50-A64
Use when the record says
  • Gonococcal Bartholin's gland abscess
Indexed under
  • Bartholinitis › gonococcal (acute) (chronic) (with abscess)
  • Gonorrhea › Cowper's gland (with abscess)
  • Paraurethritis › gonococcal (acute) (chronic) (with abscess)
  • Abscess › penis › gonococcal (accessory gland) (periurethral)
  • Abscess › periurethral › gonococcal (accessory gland) (periurethral)

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