D69 vs D89.0
D69 and D89.0 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 D69
benign hypergammaglobulinemic purpura (D89.0)
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
D89.0
Polyclonal hypergammaglobulinemia
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D80-D89
Use when the record says
- Benign hypergammaglobulinemic purpura
- Polyclonal gammopathy NOS
Indexed under
- Gammopathy › polyclonal (of undetermined significance [MGUS])
- Hypergammaglobulinemia › polyclonal
- Hypergammaglobulinemia › Waldenström
- Purpura › hypergammaglobulinemic
- Waldenström › hypergammaglobulinemia
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