Excludes1 pair
E16.2 vs E89.1
E16.2 and E89.1 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 E89.1
transient postprocedural hypoglycemia (E16.2)
E16.2
Hypoglycemia, unspecified
BillableUnspecified
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E15-E16
Indexed under
- Glycopenia
- Hypoglycemia (spontaneous)
- McQuarrie's syndrome (idiopathic familial hypoglycemia)
- Decrease › glucose
- Encephalopathy › hypoglycemic
E89.1
Postprocedural hypoinsulinemia
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E89
Use when the record says
- Postpancreatectomy hyperglycemia
- Postsurgical hypoinsulinemia
Indexed under
- Hypoinsulinemia, postprocedural
- Postpancreatectomy hyperglycemia
- Hyperglycemia, hyperglycemic › postpancreatectomy
- Postprocedural › hypoinsulinemia
- Complication › surgical procedure › hyperglycemia (postpancreatectomy)
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