Excludes1 pair
J40 vs J68.0
J40 and J68.0 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 J40
bronchitis due to chemicals, gases, fumes and vapors (J68.0)
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)
J68.0
Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J60-J70
Use when the record says
- Chemical bronchitis (acute)
Indexed under
- Bronchitis › chemical (acute) (subacute)
- Bronchitis › due to gases, fumes or vapors (chemical)
- Pneumonia › nitrogen dioxide
- Pneumonitis › chemical (due to gases, fumes or vapors) (inhalation)
- Pneumonitis › crack (cocaine)
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