Excludes1 pair

N20.9 vs N21.9

N20.9 and N21.9 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 N21.9
calculus of urinary tract NOS (N20.9)
N20.9

Urinary calculus, unspecified

BillableUnspecified
Chapter 14
Diseases of the genitourinary system
Section
N20-N23
Indexed under
  • Anuria › calculous (impacted) (recurrent)
  • Calculus, calculi, calculous › anuria (impacted) (recurrent)
  • Calculus, calculi, calculous › urinary (duct) (impacted) (passage) (tract)
  • Stone › urinary (duct) (impacted) (passage)
N21.9

Calculus of lower urinary tract, unspecified

BillableUnspecified
Chapter 14
Diseases of the genitourinary system
Section
N20-N23
Indexed under
  • Calculus, calculi, calculous › urinary › lower
  • Stone › urinary › lower tract

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