J61 vs J65
J61 and J65 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.
J61
Pneumoconiosis due to asbestos and other mineral fibers
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J60-J70
Use when the record says
- Asbestosis
Indexed under
- Amianthosis
- Asbestosis (occupational)
- Pneumoconiosis › asbestos (due to) (inhalation of)
- Pneumoconiosis › mineral fibers NEC (due to) (inhalation of)
- Fibrosis, fibrotic › lung › with › asbestosis
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 (due to) (inhalation of)
- Silicosis, silicotic › with tuberculosis (simple) (complicated)
- Tuberculosis, tubercular, tuberculous › with pneumoconiosis (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
- Tuberculosis, tubercular, tuberculous › collier's (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative)
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