E25- vs Q89.1
E25 and Q89.1 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.
Adrenogenital disorders
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E20-E35
- adrenogenital syndromes, virilizing or feminizing, whether acquired or due to adrenal hyperplasia consequent on inborn enzyme defects in hormone synthesis
- Female adrenal pseudohermaphroditism
- Female heterosexual precocious pseudopuberty
- Male isosexual precocious pseudopuberty
- Male macrogenitosomia praecox
- Male sexual precocity with adrenal hyperplasia
- Male virilization (female)
Congenital malformations of adrenal gland
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
- Aberrant › adrenal gland
- Absence › adrenal (gland) (congenital)
- Accessory › adrenal gland
- Agenesis › adrenal (gland)
- Anomaly, anomalous › adrenal (gland)
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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