FY2027
MenuClose
Excludes1 pair

F53.1 vs O90.6

F53.1 and O90.6 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 O90.6
puerperal psychosis (F53.1)
F53.1

Puerperal psychosis

Billable
Chapter 5
Mental, Behavioral and Neurodevelopmental disorders
Section
F50-F59
Use when the record says
  • Postpartum psychosis
  • Puerperal psychosis, NOS
Indexed under
  • Psychosis, psychotic › postpartum (NOS)
  • Psychosis, psychotic › puerperal (NOS)
  • Puerperal, puerperium › psychosis (NOS)
  • Pregnancy › complicated by › psychosis or psychoneurosis (puerperal)
O90.6

Postpartum mood disturbance

Billable
Chapter 15
Pregnancy, childbirth and the puerperium
Section
O85-O92
Use when the record says
  • Postpartum blues
  • Postpartum dysphoria
  • Postpartum sadness
Indexed under
  • Blues, postpartal
  • Sadness, postpartal
  • Blues, postpartal › baby
  • Dysphoria › postpartal
  • Puerperal, puerperium › mood disturbance

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