E72.4 vs H31
E72.4 and H31 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on E72.4
hereditary choroidal dystrophy (H31.2-)
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 (of)
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