Excludes1 pair

N23 vs R10-

N23 and R10 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 R10
renal colic (N23)
N23

Unspecified renal colic

BillableUnspecified
Chapter 14
Diseases of the genitourinary system
Section
N20-N23
Indexed under
  • Nephralgia
  • Ureteralgia
  • Colic › kidney
  • Colic › nephritic
  • Colic › renal
R10

Abdominal and pelvic pain

Not billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R10-R19

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