Excludes1 pair

E84.0 vs Q33.0

E84.0 and Q33.0 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 Q33.0
cystic fibrosis (E84.0)
E84.0

Cystic fibrosis with pulmonary manifestations

Billable
Chapter 4
Endocrine, nutritional and metabolic diseases
Section
E70-E88
Indexed under
  • Fibrosis, fibrotic › cystic › with › pulmonary manifestations
Q33.0

Congenital cystic lung

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q30-Q34
Use when the record says
  • Congenital cystic lung disease
  • Congenital honeycomb lung
  • Congenital polycystic lung disease
Indexed under
  • Honeycomb lung › congenital
  • Cyst › bronchogenic › congenital
  • Cyst › congenital NEC › lung
  • Cyst › lung › congenital
  • Cystic › lung disease › 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