FY2027
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Excludes1 pair

N62 vs P83.4

N62 and P83.4 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 N62
breast engorgement of newborn (P83.4)
N62

Hypertrophy of breast

Billable
Chapter 14
Diseases of the genitourinary system
Section
N60-N65
Use when the record says
  • Gynecomastia
  • Hypertrophy of breast NOS
  • Massive pubertal hypertrophy of breast
Indexed under
  • Gynecomastia
  • Mammoplasia
  • Mastoplasia, mastoplastia
  • Excess, excessive, excessively › development, breast
  • Hypertrophy, hypertrophic › breast
P83.4

Breast engorgement of newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P80-P83
Use when the record says
  • Noninfective mastitis of newborn
Indexed under
  • Mastitis › neonatal (noninfective)
  • Newborn › breast engorgement
  • Engorgement › breast › newborn
  • Hypertrophy, hypertrophic › breast › newborn
  • Newborn › mastitis › noninfective

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