What are Excludes1 and Excludes2 notes in ICD-10-CM, and how do they differ?

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In ICD-10-CM, Excludes1 and Excludes2 notes are important instructions that clarify coding rules related to certain diagnoses. They help coders understand when codes should or shouldn’t be assigned together.

Excludes1

• Indicates "NOT CODED HERE!"

• Means the two conditions cannot occur together; they are mutually exclusive.

• You should NOT code the excluded condition at the same time as the code with the Excludes1 note.

• If both conditions seem present, you must choose the correct code based on clinical documentation.

• Example: Code A has an Excludes1 note for Condition B → if Condition B exists, you do not assign Code A.

Excludes2

• Means "Not included here but the two conditions can occur together."

• You CAN code both conditions together if the patient has both.

• Excludes2 is used to highlight that the excluded condition is different but may coexist, so coding both is allowed.

• Example: Code A has an Excludes2 note for Condition B → if both conditions exist, code both.

Summary:

• Excludes1 = "Not coded here" = mutually exclusive diagnoses

• Excludes2 = "Not included here" = different but coexisting diagnoses allowed

Understanding these notes ensures accurate, compliant ICD-10-CM coding.

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