D59.6 vs R82.3
D59.6 and R82.3 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 D59.6
hemoglobinuria NOS (R82.3)
D59.6
Hemoglobinuria due to hemolysis from other external causes
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
- Hemoglobinuria from exertion
- March hemoglobinuria
- Paroxysmal cold hemoglobinuria
Indexed under
- Harley's disease
- Murri's disease (intermittent hemoglobinuria)
- Hemoglobinemia › paroxysmal
- Hemoglobinuria › with anemia, hemolytic, acquiredNEC
- Hemoglobinuria › cold
R82.3
Hemoglobinuria
Billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R80-R82
Indexed under
- Globinuria
- Hemoglobinuria
- Findings, abnormal, inconclusive, without diagnosis › hematinuria
- Findings, abnormal, inconclusive, without diagnosis › hemoglobinuria
- Abnormal, abnormality, abnormalities › urine › hemoglobin
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