Excludes1 pair
P01.1 vs P01.2
P01.1 and P01.2 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 P01.2
oligohydramnios due to premature rupture of membranes (P01.1)
P01.1
Newborn affected by premature rupture of membranes
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P00-P04
Indexed under
- Newborn › affected by › maternal › premature rupture of membranes
P01.2
Newborn affected by oligohydramnios
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P00-P04
Indexed under
- Newborn › affected by › maternal › oligohydramnios
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