FY2027
MenuClose
Excludes1 pair

O36.1- vs R76.0

O36.1 and R76.0 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 R76.0
isoimmunization in pregnancy (O36.0-O36.1)
O36.1

Maternal care for other isoimmunization

Not billable
Chapter 15
Pregnancy, childbirth and the puerperium
Section
O30-O48
Use when the record says
  • Maternal care for ABO isoimmunization
R76.0

Raised antibody titer

Billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R70-R79
Indexed under
  • Antibody › anticardiolipin
  • Antibody › antiphosphatidylglycerol
  • Antibody › antiphosphatidylinositol
  • Antibody › antiphosphatidylserine
  • Antibody › antiphospholipid

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