D47.2 vs D89
D47.2 and D89 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 D89
monoclonal gammopathy (of undetermined significance) (D47.2)
D47.2
Monoclonal gammopathy
Billable
- Chapter 2
- Neoplasms
- Section
- D37-D48
Use when the record says
- Monoclonal gammopathy of undetermined significance [MGUS]
Indexed under
- Gammopathy (of undetermined significance [MGUS])
- Gammopathy › associated with lymphoplasmacytic dyscrasia (of undetermined significance [MGUS])
- Gammopathy › monoclonal (of undetermined significance [MGUS])
- Macroglobulinemia › monoclonal (idiopathic) (primary)
- Myeloma › smoldering (multiple)
D89
Other disorders involving the immune mechanism, not elsewhere classified
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D80-D89
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