Excludes1 pair
B53.0 vs B53.1
B53.0 and B53.1 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 official note, declared on B53.1
Malaria due to simian plasmodia with Plasmodium ovale (B53.0)
B53.0
Plasmodium ovale malaria
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B50-B64
Indexed under
- Fever › Plasmodium ovale
- Malaria, malarial › ovale
- Malaria, malarial › Plasmodium › ovale
B53.1
Malaria due to simian plasmodia
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B50-B64
Indexed under
- Monkey malaria
- Simian malaria
- Malaria, malarial › Plasmodium › simian
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