Excludes1 pair
D48.0 vs D48.1-
D48.0 and D48.1 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 D48.1
neoplasm of uncertain behavior of articular cartilage (D48.0)
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
D48.1
Neoplasm of uncertain behavior of connective and other soft tissue
Not billable
- Chapter 2
- Neoplasms
- Section
- D37-D48
Use when the record says
- Neoplasm of uncertain behavior of connective tissue of ear
- Neoplasm of uncertain behavior of connective tissue of eyelid
- Stromal tumors of uncertain behavior of digestive system
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