FY2027
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Excludes1 pair

M41- vs Q76.3

M41 and Q76.3 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 M41
congenital scoliosis due to bony malformation (Q76.3)
M41

Scoliosis

Not billable
Chapter 13
Diseases of the musculoskeletal system and connective tissue
Section
M40-M43
Use when the record says
  • kyphoscoliosis
Q76.3

Congenital scoliosis due to congenital bony malformation

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q65-Q79
Use when the record says
  • Hemivertebra fusion or failure of segmentation with scoliosis
Indexed under
  • Hemivertebra › failure of segmentation with scoliosis
  • Hemivertebra › fusion with scoliosis
  • Scoliosis › congenital › due to bony malformation
  • Scoliosis › congenital › failure of segmentation (hemivertebra)
  • Scoliosis › congenital › hemivertebra fusion

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