FY2027
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Excludes1 pair

E21- vs E55.0

E21 and E55.0 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 E21
infantile and juvenile osteomalacia (E55.0)
E21

Hyperparathyroidism and other disorders of parathyroid gland

Not billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E20-E35
E55.0

Rickets, active

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E50-E64
Use when the record says
  • Infantile osteomalacia
  • Juvenile osteomalacia
Indexed under
  • Rickets (active) (acute) (adolescent) (chest wall) (congenital) (current) (infantile) (intestinal)
  • Rosary, rachitic
  • Calciferol deficiency › with rickets
  • Disease, diseased › English (rickets)
  • Morbus › angelicus, anglorum

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