FY2027
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Excludes1 pair

R04.2 vs R84-

R04.2 and R84 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 R84
blood-stained sputum (R04.2)
R04.2

Hemoptysis

Billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R00-R09
Use when the record says
  • Blood-stained sputum
  • Cough with hemorrhage
Indexed under
  • Hemoptysis
  • Sputum › blood-stained
R84

Abnormal findings in specimens from respiratory organs and thorax

Not billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R83-R89
Use when the record says
  • abnormal findings in bronchial washings
  • abnormal findings in nasal secretions
  • abnormal findings in pleural fluid
  • abnormal findings in sputum
  • abnormal findings in throat scrapings

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