L85.1 vs Q82.8
L85.1 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.
Acquired keratosis [keratoderma] palmaris et plantaris
- Chapter 12
- Diseases of the skin and subcutaneous tissue
- Section
- L80-L99
- Hyperkeratosis › palmoplantaris climacterica
- Keratoderma, keratodermia › acquired
- Keratoderma, keratodermia › climactericum
- Keratosis › palmaris et plantaris › acquired
- Tylosis › palmaris et plantaris › acquired
Other specified congenital malformations of skin
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
- 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]
- 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