Excludes1 pair
M25.0- vs M36.2
M25.0 and M36.2 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 M25.0
hemophilic arthropathy (M36.2)
M25.0
Hemarthrosis
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M20-M25
M36.2
Hemophilic arthropathy
Billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M30-M36
Use when the record says
- Hemarthrosis in hemophilic arthropathy
Indexed under
- Arthropathy › hemophilic NEC
- Arthritis, arthritic › due to or associated with › hemophilia
- Arthritis, arthritic › in › hemophilia NEC
- Arthropathy › in › hemophilia 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