FY2027
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Excludes1 pair

K22.0 vs K22.4

K22.0 and K22.4 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 K22.4
cardiospasm (K22.0)
K22.0

Achalasia of cardia

Billable
Chapter 11
Diseases of the digestive system
Section
K20-K31
Use when the record says
  • Achalasia NOS
  • Cardiospasm
Indexed under
  • Achalasia (cardia) (esophagus)
  • Aperistalsis, esophagus
  • Cardiospasm (esophagus) (reflex) (stomach)
  • Megaesophagus (functional)
  • Megaloesophagus (functional)
K22.4

Dyskinesia of esophagus

Billable
Chapter 11
Diseases of the digestive system
Section
K20-K31
Use when the record says
  • Corkscrew esophagus
  • Diffuse esophageal spasm
  • Spasm of esophagus
Indexed under
  • Bársony (-Polgár) (-Teschendorf) syndrome (corkscrew esophagus)
  • Corkscrew esophagus
  • Curling esophagus
  • Esophagismus
  • Esophagospasm

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