Excludes1 pair
C25.4 vs C75-
C25.4 and C75 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 C75
malignant neoplasm of endocrine pancreas (C25.4)
C25.4
Malignant neoplasm of endocrine pancreas
Billable
- Chapter 2
- Neoplasms
- Section
- C15-C26
Use when the record says
- Malignant neoplasm of islets of Langerhans
Indexed under
- Adenocarcinoma › islet cell › pancreas
- Adenocarcinoma › islet cell › unspecified site
- Carcinoma › islet cell › pancreas
- Carcinoma › islet cell › unspecified site
- Gastrinoma › malignant › pancreas
C75
Malignant neoplasm of other endocrine glands and related structures
Not billable
- Chapter 2
- Neoplasms
- Section
- C73-C75
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