FY2027
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Excludes1 pair

E22.0 vs E34.4

E22.0 and E34.4 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 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

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