Excludes1 pair

E10- vs R73.9

E10 and R73.9 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 E10
hyperglycemia NOS (R73.9)
E10

Type 1 diabetes mellitus

Not billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E08-E13
Use when the record says
  • brittle diabetes (mellitus)
  • diabetes (mellitus) due to autoimmune process
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction
  • idiopathic diabetes (mellitus)
  • juvenile onset diabetes (mellitus)
  • ketosis-prone diabetes (mellitus)
R73.9

Hyperglycemia, unspecified

BillableUnspecified
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R70-R79
Indexed under
  • Hyperglycemia, hyperglycemic (transient)
  • Elevated, elevation › blood sugar
  • Findings, abnormal, inconclusive, without diagnosis › blood sugar › high
  • Sugar › blood › high (transient)

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