Specificity relationship
What we found
Not ordinarily reported together for the same condition. No Excludes1/Excludes2 relationship is listed between S56.80 and S56.81, but they describe overlapping diagnoses in the same category (Both are children of the same S56 category.).
When documentation supports the more specific code, the unspecified code should generally not be added for the same condition (ICD-10-CM Official Guidelines, Section I.B.18).
What to review
When the documentation supports the more specific code, report it and leave the unspecified code off for the same condition.
Guide: Other vs unspecified (NEC vs NOS)Check these on a claim
Why it matters
No Excludes note links these codes, but they describe overlapping diagnoses and one of them is unspecified. When documentation supports the more specific code, the unspecified code should generally not be added for the same condition.
Source / rule
ICD-10-CM Official Guidelines, Section I.B.18