J06 vs J10.1
J06 and J10.1 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.
J06
Acute upper respiratory infections of multiple and unspecified sites
Not billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J00-J06
J10.1
Influenza due to other identified influenza virus with other respiratory manifestations
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J09-J18
Use when the record says
- Influenza due to other identified influenza virus NOS
- Influenza due to other identified influenza virus with laryngitis
- Influenza due to other identified influenza virus with pharyngitis
- Influenza due to other identified influenza virus with upper respiratory symptoms
Indexed under
- Influenza › novelH1N1 influenza (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
- Influenza › novel influenza A/H1N1 (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
- Influenza › due to › identified influenza virus NEC (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
- Influenza › due to › identified influenza virus NEC › with › laryngitis (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
- Influenza › due to › identified influenza virus NEC › with › pharyngitis (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
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