D38.5 vs D48.0
D38.5 and D48.0 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 D48.0
neoplasm of uncertain behavior of cartilage of nose (D38.5)
D38.5
Neoplasm of uncertain behavior of other respiratory organs
Billable
- Chapter 2
- Neoplasms
- Section
- D37-D48
Use when the record says
- Neoplasm of uncertain behavior of accessory sinuses
- Neoplasm of uncertain behavior of cartilage of nose
- Neoplasm of uncertain behavior of middle ear
- Neoplasm of uncertain behavior of nasal cavities
D48.0
Neoplasm of uncertain behavior of bone and articular cartilage
Billable
- Chapter 2
- Neoplasms
- Section
- D37-D48
Indexed under
- Ecchondrosis
- Osteoclastoma
- Tumor › giant cell › bone
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