E03.0 vs E04
E03.0 and E04 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 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 (plunging) (substernal)
- Goiter › congenital › diffuse (plunging) (substernal)
- Goiter › congenital › parenchymatous (plunging) (substernal)
- Hypothyroidism › congenital › with goiter (acquired)
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