AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 4; Ask the Editor
Excludes1 Instructional Note
We understand that the Official Guidelines for Coding and Reporting provide that “an Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note.” However, we have not been able to locate official guidance as to which code should be assigned out of the two codes. Can you help? ...
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Article Overview
This article addresses a common coding question about the meaning of an Excludes1 instructional note and how it relates to code selection when related diagnoses appear together in documentation. It is aimed at medical coders and coding educators who work with ICD-10-CM and the Alphabetical Index, and it explains the topic in the context of a brief example drawn from vascular disease and gangrene references.
Why This Topic Matters
Understanding Excludes1 notes is important because they affect how coders interpret related diagnosis entries and avoid incompatible code combinations. The article helps readers recognize the broader coding issue involved when two documented conditions appear to conflict with an instructional note in the code set.
What You Will Learn
- How an Excludes1 instructional note is described in coding guidance
- How the Alphabetical Index may present related diagnostic terms
- How the article frames a coding question involving two documented conditions
- How a short example is used to illustrate the topic
Who Should Read This
- Medical coders
- Coding educators
- Coding auditors
- Compliance staff
Codes Discussed
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