Excludes1 pair
M14- vs M36.3
M14 and M36.3 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 M14
hematological disorders (M36.2-M36.3)
M14
Arthropathies in other diseases classified elsewhere
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M05-M14
M36.3
Arthropathy in other blood disorders
Billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M30-M36
Indexed under
- Arthritis, arthritic › in › hemoglobinopathy NEC
- Arthritis, arthritic › in › thalassemia NEC
- Arthropathy › in › blood disorder NOS
- Arthropathy › in › hemoglobinopathy NEC
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