B67.3 vs E35

B67.3 and E35 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 official note, declared on E35

Echinococcus granulosus infection of thyroid gland (B67.3)

B67.3

Echinococcus granulosus infection, other and multiple sites

Not billable

Chapter 1: Certain infectious and parasitic diseases
Section: B65-B83

E35

Disorders of endocrine glands in diseases classified elsewhere

Billable

Chapter 4: Endocrine, nutritional and metabolic diseases
Section: E20-E35

Indexed under

Dubois' disease (thymus gland)
Disease, diseased › Dubois
Calcification › adrenal › tuberculous
Echinococcus › thyroid NEC › multilocularis (infection)

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