Excludes1 pair

F50.9 vs R13.0

F50.9 and R13.0 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 R13.0
psychogenic aphagia (F50.9)
F50.9

Eating disorder, unspecified

BillableUnspecified
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F50-F59
Use when the record says
  • Atypical anorexia nervosa
  • Atypical bulimia nervosa
  • Feeding or eating disorder, unspecified
  • Other specified feeding disorder
Indexed under
  • Aphagia › psychogenic
  • Bulimia › atypical
  • Bulimia › normal weight
  • Disorder › eating (adult) (psychogenic)
  • Anorexia › nervosa › atypical
R13.0

Aphagia

Billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R10-R19
Use when the record says
  • Inability to swallow
Indexed under
  • Aphagia
  • Deglutition › paralysis
  • Paralysis, paralytic › deglutition

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