Excludes1 pair

E51- vs E64.8

E51 and E64.8 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 E51
sequelae of thiamine deficiency (E64.8)
E51

Thiamine deficiency

Not billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E50-E64
E64.8

Sequelae of other nutritional deficiencies

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E50-E64
Indexed under
  • Sequelae › calcium deficiency
  • Sequelae › niacin deficiency
  • Sequelae › selenium deficiency
  • Sequelae › thiamine deficiency
  • Sequelae › vitamin deficiency NEC

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