Excludes1 pair

Q61.9 vs Q85.8-

Q61.9 and Q85.8 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 Q85.8
Meckel-Gruber syndrome (Q61.9)
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)
Q85.8

Other phakomatoses, not elsewhere classified

Not billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q80-Q89

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