D10.1 vs D10.4
D10.1 and D10.4 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 D10.4
benign neoplasm of lingual tonsil (D10.1)
D10.1
Benign neoplasm of tongue
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Benign neoplasm of lingual tonsil
Indexed under
- Myoblastoma › tongue
- Myeloblastoma › granular cell › tongue
D10.4
Benign neoplasm of tonsil
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Benign neoplasm of tonsil (faucial) (palatine)
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