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A50.51 vs M02.3

A50.51 (Clutton's joints) compared with M02.3 (Reiter's disease), from the official CMS tabular data.

Summary

These codes should not be reported together because A50.51’s tabular entry lists M02.3 under Excludes1.

Official rule
What is different?

The conditions named, billing status and chapter.A50.51 is “Clutton's joints”; M02.3 is “Reiter's disease”. M02.3 is a non-billable header; A50.51 is billable. A50.51 sits in A00-B99 — Certain Infectious and Parasitic Diseases (A00-B99); M02.3 in M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99).

Registry fact

Can these codes be reported together?

No.A50.51’s entry carries an Excludes1 note covering M02.3: “Reiter's disease (M02.3-)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.A50.51’s tabular entry: “Reiter's disease (M02.3-)”. The note covers M02.3.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. A50.51 carries 1 Excludes2 note covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.M02.3 is a non-billable header, but A50.51 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

Yes.Sequence A50.51 before M02.3: M02.3 carries a Code First instruction covering A50.51 (“congenital syphilis [Clutton's joints] (A50.5)”).

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

A50.51
Clutton's joints
↔
M02.3
Reiter's disease

What we found

No — do not report together.A50.51 carries an Excludes1 note covering M02.3: “Reiter's disease (M02.3-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Sequencing on the claim

Sequencing

Sequencing relationship

1st
A50.51
Clutton's joints
→
then
M02.3
Reiter's disease

What we found

Sequence A50.51 before M02.3

M02.3 carries a Code First instruction covering A50.51: “congenital syphilis [Clutton's joints] (A50.5)”

What to review

On a claim that carries both, list A50.51 ahead of M02.3; the manifestation is never the principal diagnosis.

Guide: Code First vs Use Additional Code vs Code Also

Why it matters

A "Code first" note means the underlying etiology is sequenced ahead of this manifestation code on the claim.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2026

  • Section I.B.7 — Multiple coding for a single condition · applies to: Code first / Use additional code

    In addition to the etiology/manifestation convention that requires two codes to fully describe a single condition that affects multiple body systems, there are other single conditions that also require more than one code. “Use additional code” notes are found in the Tabular List at codes that are not part of an etiology/manifestation pair where a secondary code is useful to fully describe a condition. The sequencing rule is the same as the etiology/manifestation pair, “use additional code” indicates that a secondary code should be added, if known. For example, for bacterial infections that are not included in chapter 1, a secondary code from category B95, Streptococcus, Staphylococcus, and Enterococcus, as the cause of diseases classified elsewhere, or B96, Other bacterial agents as the cause of diseases classified elsewhere, may be required to identify the bacterial organism causing the infection. A “use additional code” note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. “Code first” notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. When there is a “code first” note and an underlying condition is present, the underlying condition should be sequenced first, if known. […]

    ICD-10-CM Official Guidelines FY2026

  • Section I.A.13 — Etiology/manifestation convention (“code first”, “use additional code” and “in diseases classified elsewhere” notes) · applies to: Etiology/manifestation convention

    Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, “in diseases classified elsewhere.” Codes with this title are a component of the etiology/ manifestation convention. The code title indicates that it is a manifestation code. “In diseases classified elsewhere” codes are never permitted to be used as first listed or principal diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition. See category F02, Dementia in other diseases classified elsewhere, for an example of this convention. There are manifestation codes that do not have “in diseases classified elsewhere” in the title. For such codes, there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code, and the rules for sequencing apply. […]

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

A50.51Clutton's jointsM02.3Reiter's disease
Billing statusBillableNon-billable header

Report instead: M02.30, M02.311, M02.312, M02.319, M02.321

ClassificationA00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionClutton's joints is a billable ICD-10-CM diagnosis code (A50.51).Reiter's disease is a non-billable ICD-10-CM category code (M02.3).
Includes—
Reactive arthritis
Excludes1
nonspecific and nongonococcal urethritis (N34.1)
Reiter's disease (M02.3-)
Behçet's disease (M35.2)
direct infections of joint in infectious and parasitic diseases classified elsewhere (M01.-)
postmeningococcal arthritis (A39.84)
mumps arthritis (B26.85)
rubella arthritis (B06.82)
syphilis arthritis (late) (A52.77)
rheumatic fever (I00)
tabetic arthropathy [Charcôt's] (A52.16)
Excludes2
human immunodeficiency virus [HIV] disease (B20)
—
Code first—
underlying disease, such as:
congenital syphilis [Clutton's joints] (A50.5)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources