Excludes1 pair
P05- vs P05.2
P05 and P05.2 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 P05.2
newborn affected by fetal malnutrition with light for gestational age (P05.0-)
P05
Disorders of newborn related to slow fetal growth and fetal malnutrition
Not billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P05-P08
P05.2
Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P05-P08
Use when the record says
- Infant, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin and loss of subcutaneous tissue
Indexed under
- Newborn › affected by › fetal › malnutrition not light or small for gestational age
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