M25.0 vs M36.2
M25.0 and M36.2 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
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 (acute) (chronic) (nonpyogenic) (subacute)
- Arthritis, arthritic › in › hemophilia NEC (acute) (chronic) (nonpyogenic) (subacute)
- 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