Excludes1 pair
D69- vs D89.1
D69 and D89.1 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
cryoglobulinemic purpura (D89.1)
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
D89.1
Cryoglobulinemia
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
- Cryoglobulinemic purpura
- Cryoglobulinemic vasculitis
- Essential cryoglobulinemia
- Idiopathic cryoglobulinemia
- Mixed cryoglobulinemia
- Primary cryoglobulinemia
- Secondary cryoglobulinemia
Indexed under
- Cryoglobulinemia (essential) (idiopathic) (mixed) (primary) (purpura) (secondary) (vasculitis)
- Cryoglobulinemia › with lung involvement
- Purpura › cryoglobulinemic
- Vasculitis › cryoglobulinemic
- Disorder › glomerular › cryoglobulinemia
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