Excludes1 pair
D69.0 vs D69.3
D69.0 and D69.3 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 D69.0
thrombocytopenic hemorrhagic purpura (D69.3)
D69.0
Allergic purpura
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
- Allergic vasculitis
- Nonthrombocytopenic hemorrhagic purpura
- Nonthrombocytopenic idiopathic purpura
- Purpura anaphylactoid
- Purpura Henoch(-Schönlein)
- Purpura rheumatica
- Vascular purpura
Indexed under
- Henoch (-Schönlein) disease or syndrome (purpura)
- Peliosis (rheumatica)
- Schönlein (-Henoch) disease or purpura (primary) (rheumatic)
- Allergy, allergic › purpura
- Anaphylactic › purpura
D69.3
Immune thrombocytopenic purpura
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
- Hemorrhagic (thrombocytopenic) purpura
- Idiopathic thrombocytopenic purpura
- Tidal platelet dysgenesis
Indexed under
- Frank's essential thrombocytopenia
- Werlhof's disease
- Dysgenesis › tidal platelet
- Hemorrhage, hemorrhagic › purpura (primary)
- Purpura › hemorrhagic, hemorrhagica
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