FY2027
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Excludes1 pair

E72.2- vs E72.4

E72.2 and E72.4 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 E72.2
disorders of ornithine metabolism (E72.4)
E72.2

Disorders of urea cycle metabolism

Not billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E70-E88
E72.4

Disorders of ornithine metabolism

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E70-E88
Use when the record says
  • Hyperammonemia-Hyperornithinemia-Homocitrullinemia syndrome
  • Ornithinemia (types I, II)
  • Ornithine transcarbamylase deficiency
Indexed under
  • Hyperornithinemia
  • Ornithine metabolism disorder
  • Ornithinemia (Type I) (Type II)
  • Deficiency, deficient › ornithine transcarbamylase
  • Disorder › ornithine metabolism

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