FY2027
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Excludes1 pair

N93- vs P54.6

N93 and P54.6 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 N93
neonatal vaginal hemorrhage (P54.6)
N93

Other abnormal uterine and vaginal bleeding

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N80-N98
P54.6

Neonatal vaginal hemorrhage

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P50-P61
Use when the record says
  • Neonatal pseudomenses
Indexed under
  • Pseudomenses (newborn)
  • Pseudomenstruation (newborn)
  • Bleeding › vagina, vaginal › newborn
  • Hemorrhage, hemorrhagic › vagina › newborn

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