D14.0 vs H74.4
D14.0 and H74.4 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 D14.0
polyp of ear (middle) (H74.4)
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
H74.4
Polyp of middle ear
Not billable
- Chapter 8
- Diseases of the ear and mastoid process
- Section
- H65-H75
Indexed under
- Polyp, polypus › ear
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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