FY2027
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Excludes1 pair

D12.0 vs D13.3-

D12.0 and D13.3 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 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