FY2027
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Excludes1 pair

D28- vs Q50.4

D28 and Q50.4 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 D28
fimbrial cyst (Q50.4)
D28

Benign neoplasm of other and unspecified female genital organs

Not billable
Chapter 2
Neoplasms
Section
D10-D36
Use when the record says
  • adenomatous polyp
  • benign neoplasm of skin of female genital organs
  • benign teratoma
Q50.4

Embryonic cyst of fallopian tube

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q50-Q56
Use when the record says
  • Fimbrial cyst
Indexed under
  • Fimbrial cyst
  • Cyst › fimbrial (twisted)
  • Cyst › Müllerian duct
  • Cyst › paramesonephric duct
  • Cyst › congenital NEC › fallopian tube

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