Excludes1 pair

E55.0 vs N25.0

E55.0 and N25.0 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
renal rickets (N25.0)
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
N25.0

Renal osteodystrophy

Billable
Chapter 14
Diseases of the genitourinary system
Section
N25-N29
Use when the record says
  • Azotemic osteodystrophy
  • Phosphate-losing tubular disorders
  • Renal rickets
  • Renal short stature
Indexed under
  • Phosphate-losing tubular disorder
  • Pseudorickets (renal)
  • Disorder › phosphate-losing tubular
  • Disorder › tubular, phosphate-losing
  • Dwarfism › renal

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