D53.2 vs E54
D53.2 and E54 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 D53.2
scurvy (E54)
D53.2
Scorbutic anemia
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D50-D53
Indexed under
- Anemia › scorbutic (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Scorbutus, scorbutic › anemia
- Scurvy, scorbutic › anemia
E54
Ascorbic acid deficiency
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E50-E64
Use when the record says
- Deficiency of vitamin C
- Scurvy
Indexed under
- Barlow's disease
- Cheadle's disease
- Scurvy, scorbutic
- Arthritis, arthritic › scorbutic (acute) (chronic) (nonpyogenic) (subacute)
- Deficiency, deficient › ascorbic acid
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