FY2027
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Excludes1 pair

I47- vs R00.0

I47 and R00.0 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 I47
tachycardia NOS (R00.0)
I47

Paroxysmal tachycardia

Not billable
Chapter 9
Diseases of the circulatory system
Section
I30-I5A
R00.0

Tachycardia, unspecified

BillableUnspecified
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R00-R09
Use when the record says
  • Rapid heart beat
  • Sinoauricular tachycardia NOS
  • Sinus [sinusal] tachycardia NOS
Indexed under
  • Fast pulse
  • Tachycardia
  • Heart beat › rapid
  • Pulse › fast
  • Pulse › rapid

These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.

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