G96.0 vs G97.0
G96.0 and G97.0 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 G96.0
cerebrospinal fluid leak from spinal puncture (G97.0)
G97.0
Cerebrospinal fluid leak from spinal puncture
Billable
- Chapter 6
- Diseases of the nervous system
- Section
- G89-G99
Indexed under
- Complication › lumbar puncture › cerebrospinal fluid leak (s) (from) (of)
- Complication › puncture, spinal › cerebrospinal fluid leak (s) (from) (of)
- Leak, leakage › cerebrospinal fluid › from spinalpuncture
- Complication › nervous system › postprocedural › spinal fluid leak (s) (from) (of)
- Complication › postoperative › lumbar puncture › cerebrospinal fluid leak (s) (from) (of)
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