Excludes1 pair
Q01- vs Q61.9
Q01 and Q61.9 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 Q01
Meckel-Gruber syndrome (Q61.9)
Q01
Encephalocele
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q00-Q07
Use when the record says
- Arnold-Chiari syndrome, type III
- encephalocystocele
- encephalomyelocele
- hydroencephalocele
- hydromeningocele, cranial
- meningocele, cerebral
- meningoencephalocele
Q61.9
Cystic kidney disease, unspecified
BillableUnspecified
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q60-Q64
Use when the record says
- Meckel-Gruber syndrome
Indexed under
- Meckel-Gruber syndrome
- Cystic › kidney (congenital)
- Degeneration, degenerative › kidney › cystic, congenital
- Disease, diseased › cystic › kidney, congenital
- Disease, diseased › kidney › cystic (congenital)
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