Excludes1 pair
F42.4 vs F98.8
F42.4 and F98.8 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 F42.4
other specified behavioral and emotional disorders with onset usually occurring in early childhood and adolescence (F98.8)
F42.4
Excoriation (skin-picking) disorder
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F40-F48
Indexed under
- Excoriation › skin picking disorder
- Disorder › skin › picking
F98.8
Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence
BillableUnspecified
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F90-F98
Use when the record says
- Excessive masturbation
- Nail-biting
- Nose-picking
- Thumb-sucking
Indexed under
- Masturbation (excessive)
- Nose-picking
- Onanism (excessive)
- Onychophagia
- Picking, nose
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