Excludes1 pair

N39.4- vs R32

N39.4 and R32 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 N39.4
enuresis NOS (R32)
N39.4

Other specified urinary incontinence

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N30-N39
R32

Unspecified urinary incontinence

BillableUnspecified
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R30-R39
Use when the record says
  • Enuresis NOS
Indexed under
  • Enuresis
  • Incontinence
  • Incontinence › urethral sphincter
  • Incontinence › urine (urinary)
  • Insufficiency, insufficient › urethral sphincter

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