E22.0 vs E34.4
E22.0 and E34.4 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 E22.0
constitutional gigantism (E34.4)
E22.0
Acromegaly and pituitary gigantism
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
Use when the record says
- Overproduction of growth hormone
Indexed under
- Acromegaly, acromegalia
- Erdheim's syndrome (acromegalic macrospondylitis)
- Gigantism (cerebral) (hypophyseal) (pituitary)
- Launois' syndrome (pituitary gigantism)
- Macrospondylitis , acromegalic
E34.4
Constitutional tall stature
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
Use when the record says
- Constitutional gigantism
Indexed under
- Tall stature, constitutional
- Gigantism › constitutional (cerebral) (hypophyseal) (pituitary)
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