FY2027
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Excludes1 pair

D65 vs P60

D65 and P60 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 D65
in newborn (P60)
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
P60

Disseminated intravascular coagulation of newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P50-P61
Use when the record says
  • Defibrination syndrome of newborn
Indexed under
  • Defibrination › newborn
  • Fibrinolysis › newborn, transient
  • Coagulopathy › intravascular › newborn
  • Syndrome › defibrination › newborn

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