Excludes1 pair

L11.0 vs Q82.8

L11.0 and Q82.8 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 distinction is congenital vs acquired.

The official note, declared on L11.0
keratosis follicularis (congenital) [Darier-White] (Q82.8)
L11.0

Acquired keratosis follicularis

Billable
Chapter 12
Diseases of the skin and subcutaneous tissue
Section
L10-L14
Indexed under
  • Keratosis › follicularis › acquired
Q82.8

Other specified congenital malformations of skin

BillableUnspecified
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q80-Q89
Use when the record says
  • Abnormal palmar creases
  • Accessory skin tags
  • Benign familial pemphigus [Hailey-Hailey]
  • Congenital poikiloderma
  • Cutis laxa (hyperelastica)
  • Dermatoglyphic anomalies
  • Inherited keratosis palmaris et plantaris
  • Keratosis follicularis [Darier-White]
Indexed under
  • Angiomatosis
  • Bloom syndrome (-Machacek)(-Torre)
  • Brugsch's syndrome
  • Darier (-White) disease (congenital)
  • Dermatolysis (exfoliativa) (congenital)

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