D10.4 vs D10.6
D10.4 and D10.6 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 pharyngeal tonsil (D10.6)
D10.4
Benign neoplasm of tonsil
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Benign neoplasm of tonsil (faucial) (palatine)
D10.6
Benign neoplasm of nasopharynx
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Benign neoplasm of pharyngeal tonsil
- Benign neoplasm of posterior margin of septum and choanae
Indexed under
- Fibroma › nasopharynx, nasopharyngeal
- Angiofibroma › juvenile › unspecified site
- Fibroangioma › juvenile › unspecified site
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