Excludes1 pair
K52.3 vs K52.9
K52.3 and K52.9 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 K52.3
unspecified colitis (K52.9)
K52.3
Indeterminate colitis
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K50-K52
Use when the record says
- Colonic inflammatory bowel disease unclassified (IBDU)
Indexed under
- IBDU (colonic inflammatory bowel dissease unclassified)
- Colitis › indeterminate, so stated
- Disease, diseased › colonic inflammatory bowel, unclassified (IBDU)
K52.9
Noninfective gastroenteritis and colitis, unspecified
BillableUnspecified
- Chapter 11
- Diseases of the digestive system
- Section
- K50-K52
Use when the record says
- Colitis NOS
- Enteritis NOS
- Gastroenteritis NOS
- Ileitis NOS
- Jejunitis NOS
- Sigmoiditis NOS
Indexed under
- Cecitis
- Colitis (acute) (catarrhal) (chronic) (noninfective) (hemorrhagic)
- Enteritis (acute) (diarrheal) (hemorrhagic) (noninfective)
- Enterocolitis
- Gastroenteritis (acute) (chronic) (noninfectious)
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