Excludes1 pair
O03.1 vs O08.1
O03.1 and O08.1 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 O08.1
delayed or excessive hemorrhage due to incomplete abortion (O03.1)
O03.1
Delayed or excessive hemorrhage following incomplete spontaneous abortion
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O00-O08
Use when the record says
- Afibrinogenemia following incomplete spontaneous abortion
- Defibrination syndrome following incomplete spontaneous abortion
- Hemolysis following incomplete spontaneous abortion
- Intravascular coagulation following incomplete spontaneous abortion
Indexed under
- Abortion › incomplete › complicated › afibrinogenemia
- Abortion › incomplete › complicated › defibrination syndrome
- Abortion › incomplete › complicated › hemolysis
- Abortion › incomplete › complicated › hemorrhage (delayed) (excessive)
- Abortion › incomplete › complicated › intravascular coagulation
O08.1
Delayed or excessive hemorrhage following ectopic and molar pregnancy
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O00-O08
Use when the record says
- Afibrinogenemia following ectopic and molar pregnancy
- Defibrination syndrome following ectopic and molar pregnancy
- Hemolysis following ectopic and molar pregnancy
- Intravascular coagulation following ectopic and molar pregnancy
Indexed under
- Afibrinogenemia › following ectopic or molar pregnancy
- Coagulation, intravascular › following ectopic or molar pregnancy
- Defibrination › following ectopic or molar pregnancy
- Hemorrhage, hemorrhagic › excessive, following ectopic gestation (subsequent episode)
- Blood › dyscrasia › following ectopic or molar pregnancy
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