Excludes1 pair

K91.2 vs M81.8

K91.2 and M81.8 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 K91.2
malabsorption osteoporosis, postsurgical (M80.8-, M81.8)
K91.2

Postsurgical malabsorption, not elsewhere classified

BillableUnspecified
Chapter 11
Diseases of the digestive system
Section
K90-K95
Use when the record says
  • Postsurgical blind loop syndrome
Indexed under
  • Tachyalimentation
  • Malabsorption › postgastrectomy
  • Malabsorption › postsurgical
  • Malnutrition › following gastrointestinal surgery
  • Complication › surgical procedure › malabsorption NEC (postsurgical)
M81.8

Other osteoporosis without current pathological fracture

Billable
Chapter 13
Diseases of the musculoskeletal system and connective tissue
Section
M80-M85
Use when the record says
  • Drug-induced osteoporosis without current pathological fracture
  • Idiopathic osteoporosis without current pathological fracture
  • Osteoporosis of disuse without current pathological fracture
  • Postoophorectomy osteoporosis without current pathological fracture
  • Postsurgical malabsorption osteoporosis without current pathological fracture
  • Post-traumatic osteoporosis without current pathological fracture
Indexed under
  • Osteoporosis › disuse
  • Osteoporosis › specified type NEC

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