A54.0 vs A54.1
A54.0 and A54.1 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 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 (suppurating)
- Gonorrhea › Cowper's gland (acute) (chronic)
- Paraurethritis › gonococcal
- Abscess › penis › gonococcal (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Abscess › periurethral › gonococcal (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
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