J39.3 vs J67.9
J39.3 and J67.9 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.
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 (reaction) (to)
- Pneumonitis › allergic (acute) (primary)
- Pneumonitis › hypersensitivity (acute) (primary)
- 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