K22.0 vs K22.4
K22.0 and K22.4 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 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