Excludes1 pair
H33- vs H35.2-
H33 and H35.2 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 H35.2
proliferative vitreo-retinopathy with retinal detachment (H33.4-)
H35.2
Other non-diabetic proliferative retinopathy
Not billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H30-H36
Use when the record says
- Proliferative vitreo-retinopathy
- Thalassemia proliferative retinopathy
Indexed under
- Retinopathy › proliferative NEC
- Retinopathy › proliferative NEC › thalassemia
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