Excludes1 pair

J43- vs J98.3

J43 and J98.3 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 J43
compensatory emphysema (J98.3)
J43

Emphysema

Not billable
Chapter 10
Diseases of the respiratory system
Section
J40-J4B
J98.3

Compensatory emphysema

Billable
Chapter 10
Diseases of the respiratory system
Section
J96-J99
Indexed under
  • Emphysema › compensatory

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