Excludes1 pair
P08.1 vs P70.0
P08.1 and P70.0 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 P08.1
syndrome of infant of mother with gestational diabetes (P70.0)
P08.1
Other heavy for gestational age newborn
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P05-P08
Use when the record says
- Other newborn heavy- or large-for-dates regardless of period of gestation
- Usually implies a birth weight of 4000 g. to 4499 g.
Indexed under
- Heavy-for-dates NEC (infant) (4000g to 4499g)
- Large-for-dates NEC (infant) (4000g to 4499g)
- Large › baby (regardless of gestational age) (4000g to 4499g)
- Birth › weight › 4000 grams to 4499 grams
P70.0
Syndrome of infant of mother with gestational diabetes
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P70-P74
Use when the record says
- Newborn (with hypoglycemia) affected by maternal gestational diabetes
Indexed under
- Diabetes, diabetic › gestational › affecting newborn
- Hypoglycemia › in infant of diabetic mother › gestational diabetes
- Infant › of diabetic mother › gestational diabetes
- Syndrome › infant › gestational diabetes
- Newborn › affected by › maternal › gestational diabetes
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