Excludes1 pair
J20- vs J40
J20 and J40 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 distinction is acute vs chronic.
The official note, declared on J20
bronchitis NOS (J40)
J20
Acute bronchitis
Not billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J20-J22
Use when the record says
- acute and subacute bronchitis (with) bronchospasm
- acute and subacute bronchitis (with) tracheitis
- acute and subacute bronchitis (with) tracheobronchitis, acute
- acute and subacute fibrinous bronchitis
- acute and subacute membranous bronchitis
- acute and subacute purulent bronchitis
- acute and subacute septic bronchitis
J40
Bronchitis, not specified as acute or chronic
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J40-J4B
Use when the record says
- Bronchitis NOS
- Bronchitis with tracheitis NOS
- Catarrhal bronchitis
- Tracheobronchitis NOS
Indexed under
- Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous)
- Bronchitis › catarrhal (l5 years of age and above)
- Bronchitis › with › tracheitis (l5 years of age and above)
- Tracheitis › with › bronchitis (15 years of age and above)
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