Excludes1 pair
P54.3 vs P78-
P54.3 and P78 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 P78
neonatal gastrointestinal hemorrhages (P54.0-P54.3)
P54.3
Other neonatal gastrointestinal hemorrhage
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P50-P61
Indexed under
- Hemorrhage, hemorrhagic › bowel › newborn
- Hemorrhage, hemorrhagic › gastroenteric › newborn
- Hemorrhage, hemorrhagic › gastrointestinal › newborn
- Hemorrhage, hemorrhagic › intestine › newborn
- Hemorrhage, hemorrhagic › stomach › newborn
P78
Other perinatal digestive system disorders
Not billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P76-P78
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