Excludes1 pair
N13- vs N13.4
N13 and N13.4 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 N13.4
vesicoureteral-reflux with hydroureter (N13.73-)
N13
Obstructive and reflux uropathy
Not billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
N13.4
Hydroureter
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Indexed under
- Hydroureter
- Dilatation › ureter › due to obstruction
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