P55 vs R17
P55 and R17 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.
P55
Hemolytic disease of newborn
Not billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P50-P61
R17
Unspecified jaundice
BillableUnspecified
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R10-R19
Indexed under
- Jaundice (yellow)
- Icterus › conjunctiva
- Jaundice › cholestatic (yellow)
- Jaundice › symptomatic (yellow)
- Elevated, elevation › liver function › test › bilirubin
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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