ICD 10 Coding Alert

Question: In the Reader Question “Understand This Difference Between Excludes1 and Excludes2,” published in ICD-10 Coding Alert Volume 10 Number 10, you stated that “per the Excludes1 note that accompanies H65.1- (Other acute nonsuppurative otitis media), you cannot code H66.9- (Otitis media, unspecified) as the two conditions are mutually exclusive.” My question is: if the two diagnoses are reported at the same time, which of the two codes should be reported?

Indiana Subscriber

Answer: A recent AHA ICD-10-CM Coding Clinic article clarifies that, when two conditions are documented, you should “assign only the code referenced in the Excludes1 note” (AHA ICD-10-CM Coding Clinic 2018 Vol. 5, No. 4).

In other words, if both a code from H65.1- and H66.9- are documented, the Excludes1 note under H65.1- tells you that you should only document the code referenced in the Excludes1 note, which would be H66.9-.