Excludes1 pair
M54.6 vs M54.8-
M54.6 and M54.8 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 M54.8
dorsalgia in thoracic region (M54.6)
M54.6
Pain in thoracic spine
Billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M50-M54
Indexed under
- Pain › thoracic spine
- Pain › spine › thoracic
M54.8
Other dorsalgia
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M50-M54
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