FY2027
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Excludes1 pair

E72.3 vs G60.1

E72.3 and G60.1 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 E72.3
Refsum's disease (G60.1)
E72.3

Disorders of lysine and hydroxylysine metabolism

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E70-E88
Use when the record says
  • Glutaric aciduria NOS
  • Glutaric aciduria (type I)
  • Hydroxylysinemia
  • Hyperlysinemia
Indexed under
  • Glutaric aciduria
  • Hydroxylysinemia
  • Hyperlysinemia
  • Lysine and hydroxylysine metabolism disorder
  • Saccharopinuria
G60.1

Refsum's disease

Billable
Chapter 6
Diseases of the nervous system
Section
G60-G65
Use when the record says
  • Infantile Refsum disease
Indexed under
  • Heredopathia atactica polyneuritiformis
  • Refsum's disease or syndrome
  • Disease, diseased › Refsum's (heredopathia atactica polyneuritiformis)
  • Polyneuritis, polyneuritic › hereditary ataxic
  • Syndrome › Refsum's

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