Excludes1 pair
J02- vs J39.0
J02 and J39.0 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 J02
retropharyngeal abscess (J39.0)
J02
Acute pharyngitis
Not billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J00-J06
Use when the record says
- acute sore throat
J39.0
Retropharyngeal and parapharyngeal abscess
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J30-J39
Use when the record says
- Peripharyngeal abscess
Indexed under
- Abscess › parapharyngeal
- Abscess › peripharyngeal
- Abscess › postpharyngeal
- Abscess › retropharyngeal
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