Excludes1 pair

B39.2 vs J17

B39.2 and J17 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 J17
histoplasmosis pneumonia (B39.0-B39.2)
B39.2

Pulmonary histoplasmosis capsulati, unspecified

BillableUnspecified
Chapter 1
Certain infectious and parasitic diseases
Section
B35-B49
Indexed under
  • Histoplasmosis › with pneumonia NEC
  • Histoplasmosis › lung NEC
  • Histoplasmosis › capsulati › pulmonary
  • Pneumonia › in › histoplasmosis
J17

Pneumonia in diseases classified elsewhere

Billable
Chapter 10
Diseases of the respiratory system
Section
J09-J18
Indexed under
  • Pneumonia › postinfectional NEC
  • Pneumonia › rheumatic
  • Rheumatic › pneumonia
  • Bilharziasis › pulmonary NOS › pneumonia
  • Pneumonia › in › rheumatic fever

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