B51.0 vs D77
B51.0 and D77 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.
Plasmodium vivax malaria with rupture of spleen
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B50-B64
- Rupture, ruptured › spleen › due to P. vivax malaria
- Malaria, malarial › vivax › with › ruptured spleen (fever)
Other disorders of blood and blood-forming organs in diseases classified elsewhere
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D70-D77
- Purpura › scorbutic
- Splenitis › malarial (interstitial) (malignant) (nonspecific)
- Splenomegaly, splenomegalia › malarial (Bengal) (cryptogenic) (idiopathic) (tropical)
- Cyst › spleen NEC › hydatid (colloid) (mucous) (simple) (retention)
- Degeneration, degenerative › spleen › amyloid
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