Excludes1 pair
E75.5 vs E78.2
E75.5 and E78.2 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 E78.2
cerebrotendinous cholesterosis [van Bogaert-Scherer- Epstein] (E75.5)
E75.5
Other lipid storage disorders
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E70-E88
Use when the record says
- Cerebrotendinous cholesterosis [van Bogaert-Scherer-Epstein]
- Wolman's disease
Indexed under
- Van Bogaert-Scherer-Epstein disease or syndrome
- Wolman's disease
- Cholesterolosis, cholesterosis › cerebrotendinous
- Disease, diseased › triglyceride-storage
- Hyperlipidosis › hereditary NEC
E78.2
Mixed hyperlipidemia
Billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E70-E88
Use when the record says
- Broad- or floating-betalipoproteinemia
- Combined hyperlipidemia NOS
- Elevated cholesterol with elevated triglycerides NEC
- Fredrickson's hyperlipoproteinemia, type IIb or III
- Hyperbetalipoproteinemia with prebetalipoproteinemia
- Hypercholesteremia with endogenous hyperglyceridemia
- Hyperlipidemia, group C
- Tubo-eruptive xanthoma
Indexed under
- Betalipoproteinemia, broad or floating
- Broad- or floating-betalipoproteinemia
- Dysbetalipoproteinemia (familial)
- Xanthelasmatosis (essential)
- Xanthoma (s), xanthomatosis (primary) (familial) (hereditary)
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