Excludes1 pair

E56.1 vs P53

E56.1 and P53 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 E56.1
vitamin K deficiency of newborn (P53)
E56.1

Deficiency of vitamin K

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E50-E64
Indexed under
  • Menadione deficiency
  • Avitaminosis › K
  • Deficiency, deficient › menadione (vitamin K)
  • Deficiency, deficient › vitamin NOS › K
P53

Hemorrhagic disease of newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P50-P61
Use when the record says
  • Vitamin K deficiency of newborn
Indexed under
  • Minot's disease, newborn (hemorrhagic disease)
  • Disease, diseased › Minot's (hemorrhagic disease, newborn)
  • Morbus › hemorrhagicus neonatorum
  • Deficiency, deficient › menadione › newborn
  • Deficiency, deficient › thrombokinase › newborn

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