Excludes1 pair
D56- vs D57-
D56 and D57 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 D56
sickle-cell thalassemia (D57.4-)
D56
Thalassemia
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
D57
Sickle-cell disorders
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Indexed under
- Arthropathy › gouty › in › sickle-cell disorders
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