Excludes1 pair
R63.4 vs R64
R63.4 and R64 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 R64
abnormal weight loss (R63.4)
R63.4
Abnormal weight loss
Billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R50-R69
Indexed under
- Loss › weight (abnormal) (cause unknown)
- Weight › loss (abnormal) (cause unknown)
- Abnormal, abnormality, abnormalities › loss of › weight
- Excess, excessive, excessively › weight › loss
R64
Cachexia
Billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R50-R69
Indexed under
- Cachexia
- Emaciation
- Inanition
- Cachexia › cancerous
- Cachexia › malignant
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