Excludes1 pair
H43.0- vs H59-
H43.0 and H59 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 H43.0
vitreous syndrome following cataract surgery (H59.0-)
H43.0
Vitreous prolapse
Not billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H43-H44
Indexed under
- Prolapse, prolapsed › vitreous (humor)
H59
Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
Not billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H59
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