Excludes1 pair

R10- vs R52

R10 and R52 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 R52
abdomen pain (R10.-)
R10

Abdominal and pelvic pain

Not billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R10-R19
R52

Pain, unspecified

BillableUnspecified
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R50-R69
Use when the record says
  • Acute pain NOS
  • Generalized pain NOS
  • Pain NOS
Indexed under
  • Pain (s)
  • Pain › acute
  • Pain › generalized NOS

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