D58.1 vs D75.0
D58.1 and D75.0 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 D75.0
hereditary ovalocytosis (D58.1)
D58.1
Hereditary elliptocytosis
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Use when the record says
- Elliptocytosis (congenital)
- Ovalocytosis (congenital) (hereditary)
Indexed under
- Dresbach's syndrome (elliptocytosis)
- Elliptocytosis (congenital) (hereditary)
- Elliptocytosis › Hb C (congenital) (hereditary)
- Elliptocytosis › hemoglobin disease (congenital) (hereditary)
- Syndrome › Dresbach's
D75.0
Familial erythrocytosis
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D70-D77
Use when the record says
- Benign polycythemia
- Familial polycythemia
Indexed under
- Erythrocytosis › familial (megalosplenic) (secondary)
- Polycythemia › benign (secondary)
- Polycythemia › familial (secondary)
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