Excludes1 pair
E03.0 vs E04-
E03.0 and E04 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 E04
congenital goiter (NOS) (diffuse) (parenchymatous) (E03.0)
E03.0
Congenital hypothyroidism with diffuse goiter
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E00-E07
Use when the record says
- Congenital parenchymatous goiter (nontoxic)
- Congenital goiter (nontoxic) NOS
Indexed under
- Goiter › congenital (nontoxic)
- Goiter › congenital › diffuse
- Goiter › congenital › parenchymatous
- Hypothyroidism › congenital › with goiter (diffuse)
E04
Other nontoxic goiter
Not billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E00-E07
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