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D07.2 vs R87.621

D07.2 (Carcinoma in situ of vagina) compared with R87.621 (Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)), from the official CMS tabular data.

Summary

These codes should not be reported together because R87.621’s tabular entry lists D07.2 under Excludes1.

Official rule
What is different?

The conditions named and chapter.D07.2 is “Carcinoma in situ of vagina”; R87.621 is “Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)”. D07.2 sits in C00-D49 — Neoplasms (C00-D49); R87.621 in R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99).

Registry fact

Can these codes be reported together?

No.R87.621’s entry carries an Excludes1 note covering D07.2: “carcinoma in situ of vagina (histologically confirmed) (D07.2)”. 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.R87.621’s tabular entry: “carcinoma in situ of vagina (histologically confirmed) (D07.2)”. The note covers D07.2.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. R87.621 carries 5 Excludes2 notes 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?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

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

R87.621
Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)
↔
D07.2
Carcinoma in situ of vagina

What we found

No — do not report together.R87.621 carries an Excludes1 note covering D07.2: “carcinoma in situ of vagina (histologically confirmed) (D07.2)”

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

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

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

D07.2Carcinoma in situ of vaginaR87.621Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)
Billing statusBillableBillable
ClassificationC00-D49 — Neoplasms (C00-D49)R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
DefinitionCarcinoma in situ of vagina is a billable ICD-10-CM diagnosis code (D07.2).Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H) is a billable ICD-10-CM diagnosis code (R87.621).
Includes
Bowen's disease
erythroplasia
grade III intraepithelial neoplasia
Queyrat's erythroplasia
abnormal findings in secretion and smears from cervix uteri
abnormal findings in secretion and smears from vagina
abnormal findings in secretion and smears from vulva
Excludes1
moderate dysplasia of vagina (N89.1)
vaginal intraepithelial neoplasia II [VIN II] (N89.1)
melanoma in situ of trunk (D03.5)
abnormal cytological findings in specimens from cervix uteri (R87.61-)
abnormal cytological findings in specimens from other female genital organs (R87.69)
carcinoma in situ of vagina (histologically confirmed) (D07.2)
vaginal intraepithelial neoplasia I [VAIN I] (N89.0)
vaginal intraepithelial neoplasia II [VAIN II] (N89.1)
vaginal intraepithelial neoplasia III [VAIN III] (D07.2)
dysplasia (mild) (moderate) of vagina (histologically confirmed) (N89.-)
severe dysplasia of vagina (histologically confirmed) (D07.2)
abnormal findings on antenatal screening of mother (O28.-)
diagnostic abnormal findings classified elsewhere - see Alphabetical Index
Excludes2—
vaginal high risk human papillomavirus (HPV) DNA test positive (R87.811)
vaginal low risk human papillomavirus (HPV) DNA test positive (R87.821)
abnormal findings on examination of blood, without diagnosis (R70-R79)
abnormal findings on examination of urine, without diagnosis (R80-R82)
abnormal tumor markers (R97.-)
Use additional code—
code to identify acquired absence of uterus and cervix, if applicable (Z90.71-)

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.

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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