Excludes1 pair

N61- vs P39.0

N61 and P39.0 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 N61
neonatal infective mastitis (P39.0)
N61

Inflammatory disorders of breast

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N60-N65
P39.0

Neonatal infective mastitis

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P35-P39
Indexed under
  • Newborn › mastitis
  • Abscess › breast › newborn
  • Mastitis › infective › newborn
  • Mastitis › neonatal › infective
  • Newborn › mastitis › infective

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