Excludes1 pair

S82.5- vs S89-

S82.5 and S89 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 S82.5
Salter-Harris type III of lower end of tibia (S89.13-)
S82.5

Fracture of medial malleolus

Not billable
Chapter 19
Injury, poisoning and certain other consequences of external causes
Section
S80-S89
Indexed under
  • Fracture, traumatic › ankle › medial malleolus (displaced)
  • Fracture, traumatic › ankle › medial malleolus › nondisplaced
S89

Other and unspecified injuries of lower leg

Not billable
Chapter 19
Injury, poisoning and certain other consequences of external causes
Section
S80-S89

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