Excludes1 pair
T78- vs T88.6-
T78 and T88.6 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 T88.6
anaphylactic shock or reaction due to adverse food reaction (T78.0-)
T78
Adverse effects, not elsewhere classified
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- T66-T78
T88.6
Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- T80-T88
Use when the record says
- Anaphylactic shock due to adverse effect of correct drug or medicament properly administered
- Anaphylactoid reaction NOS
Indexed under
- Shock › drug › due to correct substance properly administered
- Allergy, allergic › shock › due to › adverse effect of correct medicinal substance properly administered
- Shock › anaphylactic › due to drug or medicinal substance › correct substance properly administered
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