Excludes1 pair
J61 vs J65
J61 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.
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
- Pneumoconiosis › mineral fibers NEC
- 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 (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