What is the purpose of ICD-10-CM 'includes' and 'excludes' notes?

• A. They determine the payment amount for a code
• B. They indicate the patient demographics
• C. They specify the order of disease tree
• D. They guide what conditions are included or excluded from codes; help prevent incorrect code selection

Answer: (D)

The core idea here is that includes and excludes notes shape how a code is used to describe a condition. Includes notes specify terms that are within the scope of a code, clarifying what conditions are meant to be captured by that code so you don’t miss related diagnoses. Excludes notes tell you what is not part of that code’s scope, preventing you from assigning a code for a condition that should be coded separately or with a different code. There are two types of excludes: one means the condition listed cannot be coded with the base code at all, while the other means the condition can be coded together with the base code if the patient has both. Together, these notes guide what conditions are included or excluded from codes and help prevent incorrect code selection.