D82.1 vs E32
D82.1 and E32 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 E32
aplasia or hypoplasia of thymus with immunodeficiency (D82.1)
D82.1
Di George's syndrome
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
- Pharyngeal pouch syndrome
- Thymic alymphoplasia
- Thymic aplasia or hypoplasia with immunodeficiency
Indexed under
- Alymphoplasia, thymic
- Di George's syndrome
- DiGeorge's syndrome (thymic hypoplasia)
- Pharyngeal pouch syndrome
- Alymphocytosis › thymic
E32
Diseases of thymus
Not billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
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