FY2027
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Excludes1 pair

P70.0 vs P70.1

P70.0 and P70.1 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 P70.0
newborn (with hypoglycemia) affected by maternal (pre-existing) diabetes mellitus (P70.1)
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
P70.1

Syndrome of infant of a diabetic mother

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P70-P74
Use when the record says
  • Newborn (with hypoglycemia) affected by maternal (pre-existing) diabetes mellitus
Indexed under
  • Hypoglycemia › in infant of diabetic mother
  • Infant › of diabetic mother (syndrome of)
  • Syndrome › infant › of diabetic mother
  • Newborn › affected by › maternal › diabetes mellitus (pre-existing)

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