Excludes1 pair
M14- vs M36.4
M14 and M36.4 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
hypersensitivity reactions (M36.4)
M14
Arthropathies in other diseases classified elsewhere
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M05-M14
M36.4
Arthropathy in hypersensitivity reactions classified elsewhere
Billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M30-M36
Indexed under
- Arthritis, arthritic › due to or associated with › Henoch-purpura (Schönlein)
- Arthritis, arthritic › in › Henoch purpura (-Schönlein)
- Arthritis, arthritic › in › hypersensitivity reaction NEC
- Arthropathy › in › Henoch-Schönlein purpura
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