Excludes1 pair
O26.7- vs O71.6
O26.7 and O71.6 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 O26.7
traumatic separation of symphysis (pubis) during childbirth (O71.6)
O26.7
Subluxation of symphysis (pubis) in pregnancy, childbirth and the puerperium
Not billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O20-O29
O71.6
Obstetric damage to pelvic joints and ligaments
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
Use when the record says
- Obstetric avulsion of inner symphyseal cartilage
- Obstetric damage to coccyx
- Obstetric traumatic separation of symphysis (pubis)
Indexed under
- Avulsion › symphyseal cartilage, complicating delivery (inner)
- Damage › coccyx, complicating delivery
- Separation › pubic bone, obstetrical trauma
- Separation › symphysis pubis, obstetrical trauma
- Avulsion › cartilage › symphyseal, complicating delivery (inner)
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