Excludes1 pair
I05.0 vs I34-
I05.0 and I34 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 I34
mitral valve stenosis (I05.0)
I05.0
Rheumatic mitral stenosis
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I05-I09
Use when the record says
- Mitral (valve) obstruction (rheumatic)
Indexed under
- Stenosis, stenotic › mitral (chronic) (inactive) (valve)
I34
Nonrheumatic mitral valve disorders
Not billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I30-I5A
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