P10.0 vs P10.4
P10.0 and P10.4 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on P10.0
subdural hemorrhage accompanying tentorial tear (P10.4)
P10.0
Subdural hemorrhage due to birth injury
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P10-P15
Use when the record says
- Subdural hematoma (localized) due to birth injury
Indexed under
- Birth › injury NOS › subdural hemorrhage
- Hematoma › subdural › newborn › birth injury (traumatic) (skin surface intact)
- Hemorrhage, hemorrhagic › intracranial › subdural › birth injury (concealed)
- Hemorrhage, hemorrhagic › intracranial › subdural › newborn › birth injury (concealed)
P10.4
Tentorial tear due to birth injury
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P10-P15
Indexed under
- Tear, torn › tentorial, at birth (traumatic)
- Birth › injury NOS › tentorial tear
- Hemorrhage, hemorrhagic › tentoriumNEC › newborn (concealed)
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