Excludes1 pair

B87.4 vs H94.8-

B87.4 and H94.8 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 H94.8
aural myiasis (B87.4)
B87.4

Aural myiasis

Billable
Chapter 1
Certain infectious and parasitic diseases
Section
B85-B89
Indexed under
  • Myiasis › aural
  • Myiasis › ear (external) (middle)
H94.8

Other specified disorders of ear in diseases classified elsewhere

Not billable
Chapter 8
Diseases of the ear and mastoid process
Section
H90-H94
Indexed under
  • Disorder › ear › specified NEC, in diseases classified elsewhere

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