FY2027
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Excludes1 pair

Z63.3- vs Z63.4

Z63.3 and Z63.4 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 Z63.3
absence of family member due to disappearance and death (Z63.4)
Z63.3

Absence of family member

Not billable
Chapter 21
Factors influencing health status and contact with health services
Section
Z55-Z65
Z63.4

Disappearance and death of family member

Billable
Chapter 21
Factors influencing health status and contact with health services
Section
Z55-Z65
Use when the record says
  • Assumed death of family member
  • Bereavement
Indexed under
  • Bereavement (uncomplicated)
  • Disappearance of family member
  • Death › family member (assumed)
  • Loss › parent in childhood
  • Disruption › family › due to › bereavement

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