FY2027
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Excludes1 pair

D14.0 vs D16.4

D14.0 and D16.4 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 D14.0
benign neoplasm of bone of ear (D16.4)
D14.0

Benign neoplasm of middle ear, nasal cavity and accessory sinuses

Billable
Chapter 2
Neoplasms
Section
D10-D36
Use when the record says
  • Benign neoplasm of cartilage of nose
Indexed under
  • Papilloma › Schneiderian › unspecified site
  • Schneiderian › papilloma › unspecified site
D16.4

Benign neoplasm of bones of skull and face

Billable
Chapter 2
Neoplasms
Section
D10-D36
Use when the record says
  • Benign neoplasm of maxilla (superior)
  • Benign neoplasm of orbital bone
  • Keratocyst of maxilla
  • Keratocystic odontogenic tumor of maxilla
Indexed under
  • Cyst › calcifying odontogenic › upper jaw (bone) (maxilla)

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