Excludes1 pair
J95.2 vs J98.4
J95.2 and J98.4 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 J98.4
pulmonary insufficiency following surgery (J95.1-J95.2)
J95.2
Acute pulmonary insufficiency following nonthoracic surgery
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J95
Indexed under
- Complication › surgical procedure › pulmonary insufficiency (acute)
- Insufficiency, insufficient › pulmonary › acute, following surgery (nonthoracic)
- Complication › respiratory system › postoperative › pulmonary insufficiency (acute) (after nonthoracic surgery)
J98.4
Other disorders of lung
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J96-J99
Use when the record says
- Calcification of lung
- Cystic lung disease (acquired)
- Lung disease NOS
- Pulmolithiasis
Indexed under
- Honeycomb lung
- Pneumatocele (lung)
- Pneumonitis (acute) (primary)
- Pneumopathy NEC
- Pulmolithiasis
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