K64 vs O87.2
K64 and O87.2 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 K64
hemorrhoids complicating childbirth and the puerperium (O87.2)
K64
Hemorrhoids and perianal venous thrombosis
Not billable
- Chapter 11
- Diseases of the digestive system
- Section
- K55-K64
Use when the record says
- piles
O87.2
Hemorrhoids in the puerperium
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O85-O92
Indexed under
- Puerperal, puerperium › hemorrhoids (complicated by, complications)
- Hemorrhoids › complicating › puerperium (bleeding) (without mention of degree)
- Varix › complicating › childbirth › anus or rectum (lower limb)
- Varix › complicating › puerperium › anus or rectum (lower limb)
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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