J93 vs P25.1
J93 and P25.1 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 J93
congenital or perinatal pneumothorax (P25.1)
P25.1
Pneumothorax originating in the perinatal period
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P19-P29
Indexed under
- Pneumothorax NOS › congenital
- Pneumothorax NOS › perinatal period
- Pneumothorax NOS › spontaneous NOS › newborn
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