Excludes1 pair
O02.0 vs O02.1
O02.0 and O02.1 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 O02.1
missed abortion with blighted ovum (O02.0)
O02.0
Blighted ovum and nonhydatidiform mole
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O00-O08
Use when the record says
- Carneous mole
- Fleshy mole
- Intrauterine mole NOS
- Molar pregnancy NEC
- Pathological ovum
Indexed under
- Blighted ovum
- Breus' mole
- Carneous mole
- Fleshy mole
- Molar pregnancy
O02.1
Missed abortion
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O00-O08
Use when the record says
- Early fetal death, before completion of 20 weeks of gestation, with retention of dead fetus
Indexed under
- Abortion › missed
- Missed › abortion
- Dead › fetus, retained › early pregnancy
- Retention › products of conception › early pregnancy (dead fetus)
- Delivery › complicated › by › intrauterine fetal death, early
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