Excludes1 pair
F95- vs F98.5
F95 and F98.5 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 F98.5
tic disorders (F95.-)
F95
Tic disorder
Not billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F90-F98
F98.5
Adult onset fluency disorder
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F90-F98
Indexed under
- Stuttering › adult onset
- Disorder › fluency › adult onset
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