Excludes1 vs Excludes2 in ICD-10

Understanding the difference between Excludes1 and Excludes2 notes is one of the most critical skills in ICD-10 coding. As defined in the official ICD-10 coding guidelines, these notes appear throughout the classification and have very different meanings that directly impact whether codes can be used together.

Excludes1 - "NOT CODED HERE"

An Excludes1 note indicates a "pure" exclusion - meaning that the code excluded should never be used at the same time as the code above the Excludes1 note. The two conditions cannot occur together by definition.

Critical Rule

Excludes1 codes are mutually exclusive. If you code one, you cannot code the other for the same encounter. Doing so will likely result in claim denial.

Examples of Excludes1

  • Congenital absence of organ vs acquired absence of organ
  • Acute vs chronic forms of the same condition (when they can't coexist)
  • Different stages of disease progression that are mutually exclusive

Excludes2 - "NOT INCLUDED HERE"

An Excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. If both conditions are documented, both codes may be assigned.

Key Point

Excludes2 simply means the excluded condition is a separate diagnosis. Both codes can be reported together when both conditions are documented.

Examples of Excludes2

  • Asthma with COPD - both can exist and be coded
  • Diabetes with hypertension - separate conditions, both coded
  • Related but distinct conditions that commonly occur together

Side-by-Side Comparison

Feature Excludes1 Excludes2
Meaning "NOT CODED HERE" "NOT INCLUDED HERE"
Can codes be used together? No - mutually exclusive Yes - if both conditions exist
Conditions relationship Cannot occur together Can occur together
Claim impact Will likely be denied Both accepted if documented

Validate Against ICD 10 CM Coding Guidelines

Our Code Auditor automatically detects Excludes1 conflicts based on official FY2026 guidelines.

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Look up ICD 10 CM codes to find diagnosis codes before validation.

Best Practices

  • Always check Excludes notes when assigning codes
  • For Excludes1: Choose the most appropriate code based on documentation
  • For Excludes2: Code both conditions if both are documented
  • Use validation tools to catch Excludes1 violations before claim submission

Excludes1 violations are one of the most common ICD-10 coding errors that lead to claim denials. Our Code Auditor can help identify these issues automatically.

Frequently Asked Questions

Excludes1 means "NOT CODED HERE" - the codes are mutually exclusive and can never be reported together. Excludes2 means "NOT INCLUDED HERE" - the condition is not part of the code but both codes can be reported if both conditions exist.

Generally no. Excludes1 indicates the two conditions cannot occur together. However, there are rare exceptions when the conditions affect different anatomical sites or are clearly unrelated, but these require careful review.

Validate Against ICD 10 CM Coding Guidelines (FY2026)

Our ICD-10 Code Auditor validates Excludes1 rules based on official guidelines to prevent claim denials.