Excludes1 pair
N83.6 vs N85.7
N83.6 and N85.7 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 N83.6
hematometra (N85.7)
N83.6
Hematosalpinx
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Indexed under
- Hematosalpinx
- Hemosalpinx
- Hemorrhage, hemorrhagic › fallopian tube
- Hemorrhage, hemorrhagic › oviduct
N85.7
Hematometra
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Hematosalpinx with hematometra
Indexed under
- Hematometra
- Hemorrhage, hemorrhagic › intrauterine
- Hematosalpinx › with › hematometra
- Hemosalpinx › with › hematometra
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