FY2027
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Excludes1 pair

K63.1 vs K63.3

K63.1 and K63.3 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 K63.3
ulcer of intestine with perforation (K63.1)
K63.1

Perforation of intestine (nontraumatic)

Billable
Chapter 11
Diseases of the digestive system
Section
K55-K64
Use when the record says
  • Perforation (nontraumatic) of rectum
Indexed under
  • Perforation, perforated › bowel
  • Perforation, perforated › colon
  • Perforation, perforated › ileum
  • Perforation, perforated › intestine NEC
  • Perforation, perforated › jejunum, jejunal
K63.3

Ulcer of intestine

Billable
Chapter 11
Diseases of the digestive system
Section
K55-K64
Use when the record says
  • Primary ulcer of small intestine
Indexed under
  • Stercoraceous, stercoral ulcer
  • Erosion › intestine
  • Ulcer, ulcerated, ulcerating, ulceration, ulcerative › intestine, intestinal
  • Ulcer, ulcerated, ulcerating, ulceration, ulcerative › primary of intestine
  • Ulcer, ulcerated, ulcerating, ulceration, ulcerative › rectosigmoid

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