J47 vs Q33.4
J47 and Q33.4 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 J47
congenital bronchiectasis (Q33.4)
J47
Bronchiectasis
Not billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J40-J4B
Use when the record says
- bronchiolectasis
Q33.4
Congenital bronchiectasis
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q30-Q34
Indexed under
- Bronchiectasis › congenital (cylindrical) (diffuse) (fusiform) (localized) (saccular)
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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