Excludes 1 and Excludes 2
Published On - June 15, 2020
Remember there is Includes and Excludes 1 and Excludes
2.
Includes is that code includes all the terms listed
below the code.
Excludes 1 is pure excludes, meaning, that condition
will never occur with this condition. For example, a type 1 diabetic cannot
also be type 2 diabetic. Both conditions are excludes 1. Another example is a
congenital condition versus acquired condition. Both cannot occur together.
Excludes 2 is is the same. But with a slight
difference. It may sometimes be coded together. Meaning, both the conditions
may occur together rarely. It is okay to code both conditions together in that
scenario.
Example :
As an
example of Excludes 2, I10 Essential
(primary) hypertension has a note that lets you know that if the
essential hypertension involves brain vessels, you should use a code from
I60-I69 instead because I10 does not represent that condition. But if the
patient is diagnosed with both essential hypertension and essential
hypertension involving vessels of the brain, it is acceptable to report both
I10 and a code from I60-I69 on the same claim. In the code set, the note
appears like this under I10:
Excludes2:
essential (primary) hypertension involving vessels of brain (I60-I69).
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