D07.4 vs N48.0
D07.4 and N48.0 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 N48.0
carcinoma in situ of penis (D07.4)
D07.4
Carcinoma in situ of penis
Billable
- Chapter 2
- Neoplasms
- Section
- D00-D09
Use when the record says
- Erythroplasia of Queyrat NOS
Indexed under
- Erythroplasia (Queyrat)
- Queyrat's erythroplasia
- Erythroplasia › unspecified site (Queyrat)
- Queyrat's erythroplasia › penis
- Queyrat's erythroplasia › unspecified site
N48.0
Leukoplakia of penis
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N40-N53
Use when the record says
- Balanitis xerotica obliterans
- Kraurosis of penis
- Lichen sclerosus of external male genital organs
Indexed under
- Balanitis › xerotica obliterans (circinata) (erosiva) (gangrenosa) (phagedenic) (vulgaris)
- Kraurosis › penis
- Leukoplakia › penis
- Disease, diseased › white-spot, meaning lichen sclerosus et atrophicus › penis
- Lichen › albus › penis
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