Excludes1 pair
Z63.0 vs Z70-
Z63.0 and Z70 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 Z63.0
counseling related to sexual attitude, behavior, and orientation (Z70.-)
Z63.0
Problems in relationship with spouse or partner
Billable
- Chapter 21
- Factors influencing health status and contact with health services
- Section
- Z55-Z65
Use when the record says
- Relationship distress with spouse or intimate partner
Indexed under
- Conjugal maladjustment
- Marital conflict
- Conflict › marital
- Distress › relationship, with spouse or intimate partner
- Maladjustment › conjugal
Z70
Counseling related to sexual attitude, behavior and orientation
Not billable
- Chapter 21
- Factors influencing health status and contact with health services
- Section
- Z69-Z76
Use when the record says
- encounter for mental health services for sexual attitude, behavior and orientation
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