E79 vs Q82.8
E79 and Q82.8 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 E79
Bloom's syndrome (Q82.8)
E79
Disorders of purine and pyrimidine metabolism
Not billable
- Chapter 4
- Endocrine, nutritional and metabolic diseases
- Section
- E70-E88
Q82.8
Other specified congenital malformations of skin
BillableUnspecified
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
Use when the record says
- Abnormal palmar creases
- Accessory skin tags
- Benign familial pemphigus [Hailey-Hailey]
- Congenital poikiloderma
- Cutis laxa (hyperelastica)
- Dermatoglyphic anomalies
- Inherited keratosis palmaris et plantaris
- Keratosis follicularis [Darier-White]
Indexed under
- Angiomatosis
- Bloomsyndrome (-Machacek)(-Torre)
- Brugsch's syndrome
- Darier (-White) disease (congenital)
- Dermatolysis (exfoliativa) (congenital)
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