FY2027
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Excludes1 pair

D47.2 vs E88.0-

D47.2 and E88.0 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 E88.0
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
  • Gammopathy › monoclonal
  • Macroglobulinemia › monoclonal (essential)
  • Myeloma › smoldering
E88.0

Disorders of plasma-protein metabolism, not elsewhere classified

Not billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E70-E88

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