Excludes1 pair

J60 vs J65

J60 and J65 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 J60
coalworker pneumoconiosis with tuberculosis, any type in A15 (J65)
J60

Coalworker's pneumoconiosis

Billable
Chapter 10
Diseases of the respiratory system
Section
J60-J70
Use when the record says
  • Anthracosilicosis
  • Anthracosis
  • Black lung disease
  • Coalworker's lung
Indexed under
  • Anthracosilicosis
  • Anthracosis (lung) (occupational)
  • Carbon lung
  • Coalworker's lung or pneumoconiosis
  • Collier's asthma or lung
J65

Pneumoconiosis associated with tuberculosis

Billable
Chapter 10
Diseases of the respiratory system
Section
J60-J70
Use when the record says
  • Any condition in J60-J64 with tuberculosis, any type in A15
  • Silicotuberculosis
Indexed under
  • Silicotuberculosis
  • Pneumoconiosis › with tuberculosis (any type in A15)
  • Silicosis, silicotic › with tuberculosis
  • Tuberculosis, tubercular, tuberculous › with pneumoconiosis (any condition in J60-J64)
  • Tuberculosis, tubercular, tuberculous › collier's

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