FY2027
MenuClose
Excludes1 pair

I11- vs I51.7

I11 and I51.7 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 I51.7
cardiomegaly 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
I51.7

Cardiomegaly

Billable
Chapter 9
Diseases of the circulatory system
Section
I30-I5A
Use when the record says
  • Cardiac dilatation
  • Cardiac hypertrophy
  • Ventricular dilatation
Indexed under
  • Preponderance, left or right ventricular
  • Athlete's › heart
  • Cardiomegaly › idiopathic
  • Hypertrophy, hypertrophic › cardiac (chronic) (idiopathic)

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