Excludes1 pair
D69- vs D89.0
D69 and D89.0 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
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
- Hypergammaglobulinemia › polyclonal
- Hypergammaglobulinemia › Waldenström
- Purpura › hypergammaglobulinemic (benign) (Waldenström)
- 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