Excludes1 pair
J39.3 vs J67.9
J39.3 and J67.9 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 J39.3
extrinsic allergic alveolitis (J67.9)
J39.3
Upper respiratory tract hypersensitivity reaction, site unspecified
BillableUnspecified
- Chapter 10
- Diseases of the respiratory system
- Section
- J30-J39
Indexed under
- Hypersensitive, hypersensitiveness, hypersensitivity › reaction › upper respiratory tract NEC
J67.9
Hypersensitivity pneumonitis due to unspecified organic dust
BillableUnspecified
- Chapter 10
- Diseases of the respiratory system
- Section
- J60-J70
Use when the record says
- Allergic alveolitis (extrinsic) NOS
- Hypersensitivity pneumonitis NOS
Indexed under
- Allergy, allergic › alveolitis (extrinsic)
- Pneumonitis › allergic (due to)
- Pneumonitis › hypersensitivity
- Obstruction, obstructed, obstructive › airway › with › allergic alveolitis
- Disease, diseased › lung › obstructive › with › alveolitis, allergic
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