D12.0 vs D13.3
D12.0 and D13.3 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 D13.3
benign neoplasm of ileocecal valve (D12.0)
D12.0
Benign neoplasm of cecum
Billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
Use when the record says
- Benign neoplasm of ileocecal valve
Indexed under
- Polyp, polypus › colon › adenomatous › cecum
D13.3
Benign neoplasm of other and unspecified parts of small intestine
Not billable
- Chapter 2
- Neoplasms
- Section
- D10-D36
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