FY2027
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Excludes1 pair

B00.2 vs K12-

B00.2 and K12 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 K12
herpesviral [herpes simplex] gingivostomatitis (B00.2)
B00.2

Herpesviral gingivostomatitis and pharyngotonsillitis

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
B00-B09
Use when the record says
  • Herpesviral pharyngitis
Indexed under
  • Pharyngotonsillitis, herpesviral
  • Gingivostomatitis › herpesviral
  • Herpes, herpesvirus, herpetic › gingivostomatitis
  • Herpes, herpesvirus, herpetic › pharyngitis, pharyngotonsillitis
  • Herpes, herpesvirus, herpetic › stomatitis
K12

Stomatitis and related lesions

Not billable
Chapter 11
Diseases of the digestive system
Section
K00-K14

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