Excludes1 pair
J18.0 vs J69.1
J18.0 and J69.1 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 J18.0
lipid pneumonia (J69.1)
J18.0
Bronchopneumonia, unspecified organism
BillableUnspecified
- Chapter 10
- Diseases of the respiratory system
- Section
- J09-J18
Indexed under
- Bronchoalveolitis
- Pneumonia › broncho-, bronchial (confluent) (croupous) (diffuse) (disseminated) (hemorrhagic) (involving lobes) (lobar) (terminal)
J69.1
Pneumonitis due to inhalation of oils and essences
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J60-J70
Use when the record says
- Exogenous lipoid pneumonia
- Lipid pneumonia NOS
Indexed under
- Pneumonia › lipid, lipoid (exogenous)
- Pneumonia › broncho-, bronchial › lipid, lipoid
- Pneumonitis › due to › oils, essences
- Pneumonia › aspiration › due to › oils, essences
- Pneumonia › broncho-, bronchial › inhalation › of oils or essences
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