E52 vs E64.8
E52 and E64.8 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 E52
sequelae of niacin deficiency (E64.8)
E52
Niacin deficiency [pellagra]
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E50-E64
Use when the record says
- Niacin (-tryptophan) deficiency
- Nicotinamide deficiency
- Pellagra (alcoholic)
Indexed under
- Niacindeficiency (amide)
- Nicotinic acid deficiency
- Pellagra (alcoholic)
- Alcohol, alcoholic, alcohol-induced › pellagra
- Avitaminosis › nicotinic acid (multiple)
E64.8
Sequelae of other nutritional deficiencies
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E50-E64
Indexed under
- Sequelae › calcium deficiency (of)
- Sequelae › niacin deficiency (of)
- Sequelae › selenium deficiency (of)
- Sequelae › thiamine deficiency (of)
- Sequelae › vitamin deficiency NEC (of)
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