Excludes1 pair
E55.0 vs E64.3
E55.0 and E64.3 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 E55.0
inactive rickets (E64.3)
E55.0
Rickets, active
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E50-E64
Use when the record says
- Infantile osteomalacia
- Juvenile osteomalacia
Indexed under
- Rickets (active) (acute) (adolescent) (chest wall) (congenital) (current) (infantile) (intestinal)
- Rosary, rachitic
- Calciferol deficiency › with rickets
- Disease, diseased › English (rickets)
- Morbus › angelicus, anglorum
E64.3
Sequelae of rickets
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E50-E64
Indexed under
- Bowleg › rachitic
- Craniotabes › rachitic
- Deformity › rachitic, old or healed (acquired)
- Genu › rachitic (old)
- Hammer toe NEC › sequelae of rickets (late effect)
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