E86 vs T79.4
E86 and T79.4 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 E86
traumatic hypovolemic shock (T79.4)
T79.4
Traumatic shock
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- T79
Use when the record says
- Shock (immediate) (delayed) following injury
Indexed under
- Feeble rapid pulse due to shock following injury
- Decrease › respiration, due to shock following injury (d)
- Hypovolemia › traumatic
- Pulse › feeble, rapid due to shock following injury
- Rapid › feeble pulse, due to shock, following injury
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