FY2027
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Excludes1 pair

N60- vs N60.1-

N60 and N60.1 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 N60.1
diffuse cystic mastopathy with epithelial proliferation (N60.3-)
N60

Benign mammary dysplasia

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N60-N65
Use when the record says
  • fibrocystic mastopathy
N60.1

Diffuse cystic mastopathy

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N60-N65
Use when the record says
  • Cystic breast
  • Fibrocystic disease of breast
Indexed under
  • Mastopathy, mastopathia › cystic (chronic) (diffuse)

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