Excludes1 pair

D82.1 vs E32.8

D82.1 and E32.8 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 E32.8
aplasia or hypoplasia 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 (with immunodeficiency)
E32.8

Other diseases of thymus

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E20-E35
Indexed under
  • Kopp's asthma
  • Lymphatism
  • Thymitis
  • Asthma, asthmatic › Kopp's
  • Asthma, asthmatic › thymic

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