Excludes1 pair
D65 vs D69-
D65 and D69 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 D69
purpura fulminans (D65)
D65
Disseminated intravascular coagulation [defibrination syndrome]
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D65-D69
Use when the record says
- Afibrinogenemia, acquired
- Consumption coagulopathy
- COVID-19 associated diffuse or disseminated intravascular coagulopathy
- Diffuse or disseminated intravascular coagulation [DIC]
- Fibrinolytic hemorrhage, acquired
- Fibrinolytic purpura
- Purpura fulminans
Indexed under
- Defibrination (syndrome)
- Fibrinolysis (hemorrhagic) (acquired)
- Proteolysis, pathologic
- Afibrinogenemia › acquired
- Coagulation, intravascular › COVID-19 associated
D69
Purpura and other hemorrhagic conditions
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D65-D69
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