I11 vs I51.5
I11 and I51.5 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 I51.5
myocardial degeneration due to hypertension (I11.-)
I11
Hypertensive heart disease
Not billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I10-I1A
Use when the record says
- any condition in I50.- or I51.4-I51.7, I51.89, I51.9 due to hypertension
I51.5
Myocardial degeneration
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I30-I5A
Use when the record says
- Fatty degeneration of heart or myocardium
- Myocardial disease
- Senile degeneration of heart or myocardium
Indexed under
- Cardiomalacia
- Cardiomyoliposis
- Myocytolysis
- Degeneration, degenerative › myocardial, myocardium
- Disease, diseased › myocardium, myocardial
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