Excludes1 pair
E25.0 vs E30.1
E25.0 and E30.1 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 E30.1
congenital adrenal hyperplasia (E25.0)
E25.0
Congenital adrenogenital disorders associated with enzyme deficiency
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
Use when the record says
- Congenital adrenal hyperplasia
- 21-Hydroxylase deficiency
- Salt-losing congenital adrenal hyperplasia
Indexed under
- Adrenogenitalism, congenital
- Adrenogenital syndrome › congenital
- Adrenogenital syndrome › salt loss
- Defect, defective › 3-beta-hydroxysteroid dehydrogenase
- Defect, defective › 11-hydroxylase
E30.1
Precocious puberty
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
Use when the record says
- Precocious menstruation
Indexed under
- Precocity, sexual (constitutional) (cryptogenic) (female) (idiopathic) (male)
- Pubarche, precocious
- Pubertas praecox
- Breast › buds
- Buds › breast
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