Instructional notes can be found in different areas of the codebook and may not apply to all codesWherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. Basically stated, ICD-10-CM requires you to sequence the underlying condition first “if applicable, followed by the manifestation. 2 b. 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. Code first underlying disease *appears when the category is not to be used as the primary diagnosis *may not be used as the first code *Must always be preceded by another code for the primary diagnosis . 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. When you look up code H36 in the ICD-10-CM, there is an instructional note: "Code first underlying disease, such as. that it is a pure excludes note. 80 Dementia in other diseases classified elsewhere without behavioral disturbance referenced with the “see” note to locate the correct code. 1 directs to use an additional code to identify pneumonia or other manifestations. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 'Rationale: In the ICD-10-CM Alphabetic Index look for Polyneuropathy/in (due to) deficiency (of)/B (-complex) vitamins guiding you to codes E53. A query may be necessary to clarify if the. NOS. False-can not code from just index. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. these codes are a component of the etiology/manifestation convention (never permitted to be used as first listed or principal diagnosis codes) CODE ALSO (Instructional) Note. About Quizlet; How Quizlet works; Careers; Advertise with us; Get the app; For students. See Note: an instruction following the main term in the Alphabetic Index that indicates that another term should be referenced - for correct coding it is necessary to go to the main term referenced with this note. To select a code in the classification that corresponds to a diagnosis or reason for visit documented in a medical record, first locate the term in the Alphabetic Index, and then verify the code in the Tabular List. The “code first” note is an instructional note. -) and then the heart failure (I50. 8, B96. I44. D) Both codes must be used. These notes are used to signal that, when there is an underlying etiology and multiple body system manifestation due to the underlying etiology, two codes are needed. For conditions that have both an underlying etiology and multiple body. In other words, you should code the hypertension (I11. Note Used to define, give examples, or both, of the content of a category of ICD-10-CM or of a block of category codes. When an Excludes _____ note appears under a code, it is acceptable to use both the code and the excluded code together. Squamous cell b. The conventions for the ICD-10-CM are the general rules for use of the classification independent of the guidelines. 1. Chapter 3 Cengage For each item listed, indicate the type of instructional note found. 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. 81, Dementia in other diseases classified elsewhere, with behavioral disturbance. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List. 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. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. 2 Rationale: Code N94. %PDF-1. 4. is used in the Tabular. This instructional note in the tabular of the I-10 directs the coder regarding sequencing. General notes. C. The manifestation code may. Further review of the codes in this category show that 5 th character 2 indicates second trimester, resulting in code O46. Identify the tentative code(s) associated with the most appropriate subterm(s). Refer to any instructional notations in the Tabular 7. The “code first” note informs us of two things, says Allen Frady, RN, BSN, CCDS, CCS, CDI education specialist at ACDIS. Use d. for sequencing instructions for COVID-19 and sepsis. These instructional notes indicate the proper sequencing order of the codes, etiology followed by 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. 3. The meaning-first approach to reading instruction places the emphasis on getting students engaged in whole, complete texts first then teaching. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. Last option is the right answer. In the Tabular List the description is Polyneuropathy in other diseases classified elsewhere. 22. Includes. Indicates that it is a manifestation code. ICD-10-CM; ICD-10-PCS;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. J30. 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. A patient is admitted for a wedge resection of metastatic carcinoma to the liver. Question 8 Selected Answer: d. Answer: The code that represents the. All codes in ICD-10-CM Chapter 10. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. tex. Study with Quizlet and memorize flashcards containing terms like Format. 2 has an Excludes1 note for psychogenic vaginismus (F52. Assign the verified codes. MLN6447308 September 2020 Page 8 of 13 Diagnosis Coding:. An instructional note will be found at the infection code advising that an additional organism code is required. 3. Which of the following diagnosis would require a Z code. This issue was raised during discussion regarding the assignment of additional codes ‘to identify the specific condition’ when assigning codes from O98 Maternal infectious and parasitic diseases classifiable elsewhere but. A “code also” note is an instruction that two codes may be required to fully describe a condition, but the seque ncing of the two codes depends on the severity of the conditions and the reason for the office visit. The appropriate 7th character is to be added to each code from category S62: A Initial encounter for closed fracturecoding conventions (rules) usually found at the beginning of CM/PCS coding manuals general rules used in classification, independent of coding guidelines incorporated into CM/PCS instructional notes general coding conventions: + default codes - in CM, a code listed next to a main term in CM indexes; represents that condition is most commonly. Instructs that there is another main term that may also be referenced that may provide additional alphabetic index entries that may be useful. . True ____ carcinoma is primary neoplasm of the liver. instructional notes. E78. Instructional Notes General notes Inclusion and exclusion notes Code first notes Use additional code notes, and Code also notes 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. When an Excludes _____ note appears under a code, it is acceptable to use both the code and the excluded code together. provide general information on usage in a specific section. In ICD-10-CM, there is an Instructional note to code the malignancy first even when the encounter is for the management of anemia due to the malignancy. The includes note is used to define, give examples, or both, of the content of a category of ICD-10-CM or of a block of category codes. List the instructional. precalculus. In most cases the manifestation codes will have in the code title, 'in diseases classified elsewhere. d. When an Excludes 2 note appears under a code, it is acceptable to both the code and the excluded code together. When located at the beginning of a chapter or section in ICD 10 CM that advice applies to all codes within the chapter or section and will not be repeated again. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. According to ICD-10-CM Guidelines, it is not necessary to identify infections documented as antibiotic resistant. 'Instructional notes include. Refer to the Tabular List and identify the code that contains an instructional note that indicates that two related conditions cannot occur together. [Brackets] are an ICD-10-CM convention indicating the enclosed code is a manifestation code Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms ("and," "with," "without," "due to"). Chapter 18 of ICD-10-CM, Symptoms, Signs, and Abnormal Clinical and Laboratory Findings Not Elsewhere Classified (codes R00-R99) contain many, but not all codes for symptoms. This is addressed in guideline 1. esmer02. -Read the code title. 2x-3y=-2 x+y=-6. These instructional notes indicate the proper sequencing order of the codes, etiology followed by. 3. Group of answer choices. 92XB, which instructional notes appear in the ICD-10-CM conventions? Select all that apply. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Atrioventricular block, first degree Billable Code. defines and or gives examples of the content of a particular category. -)Whereby to chain ICD-10-CM codes to determine proper payment. 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. 2. Basic Coding Steps. ' Codes with this title are a component of the etiology/ manifestation. The Alphabetic Index and Tabular List. Code set that is based on a system maintained by the World Health Organization of the United Nations; codes are mandated by HIPAA for reporting patients' diseases, conditions, and signs and symptoms. In most cases the manifestation codes will have in the code title, "in diseases. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. , The "See Also" instructional note refers the coder to another location in the Tabular List. for use with latex. Adjustment disorder with anxiety Billable Code. Code First Instructional Note. In most cases the manifestation codes will have in the code title, "in diseases. 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 The Code Also note is used in ICD-10-CM to instruct the coder that two codes may be needed to fully code a diagnostic phrase. I25. A code to identify resistance to antimicrobial drugs (Z16. 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. subcategories, and valid codes. -read and follow any instructional notes . Includes note. Explain in a few sentences. These instructional notes indicate the proper. True Medical documentation should be detailed to support the granularity of the codes present in ICD-10-CM. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 02 herpes , scrotum Provide : ICD - 10 - CM Code ( s ) and the term ( s ) you referenced to obtain the code ( s ) . The "CODE FIRST" instructional note is used in the Tabular List. The instructional notation that appears for the code for a drug induced fever is ________ . An instructional note in the Tabular List instructs us to use an additional code to identify alcohol and/or tobacco use and/or dependence, history of tobacco dependence, and/or exposure to tobacco smoke. G20 Parkinson’s disease. Wherever this combination. esmer02. A query may be necessary to clarify if the. True. the coder must follow all _____________ to ensure that more specific subterms or other ______ are not overlooked. that it is a pure excludes note. 4. The term you’re looking for might not be one of the main terms in the index, but it might be listed under one of those main terms. Refer to other codes as instructed. 0. Code H27. In most cases the manifestation codes will have in the code title, 'in diseases classified elsewhere. 5. The "Code first underlying disease" instructional note found under certain codes is a sequencing rule. 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. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . The instructional notation "USE ADDITIONAL CODE" instructs the coder to: Add a second code to fully code the diagnosis. The Alphabetic Index and Tabular List. B) The code in the square brackets is a manifestation of the first code. It can be time-consuming and expensive. Inpatient Coding Support;F43. 4);” 2. The list of coded instructions is called Computer program. From Date should be less than To Date Please select From Date and To Date. 13) and for the COPD and asthma (493. It is acceptable to use only the Alphabetic index to assign I-10 codes. 7th Character Certain ICD-10-CM categories have applicable 7th characters. Etiology code is reported first, followed by the manifestation code. Instructional notes provide guidance to the coder by defining and/or giving examples of the content of a category. If you see “in diseases classified elsewhere” terminology you will assign two codes, with the manifestation code being sequenced after the underlying condition. The 2019 Guidelines added “either under a. “Code, if applicable, a causal condition first” note indicates that a code from category R35 may be assigned as a first-listed or principal diagnosis when the causal condition is unknown or not applicable. instructional notes. Study with Quizlet and memorize flashcards containing terms like This instructional note in tabular of the 1-10 directs the coder regarding sequence?, If there is 7th characters assign for an 1-10 code, but there are only five characters in the terminal code, the 6th character terminal code, the 6th character would be?, Code if applicable, any causal condition. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9-CM. 5 also applies to the following:The main term Fibrosarcoma has a note to see also Neoplasm, connective tissue, malignant. An eponym is:-the same as a synonym-the same as an anomaly-named after a person-the study of disease. See also instructional note Refers the coder to another location in the alphabetic index when the initial listing does not contain all the necessary information to accurately select a code. TRUE. ICD 10 Code Description Notes E08. It is necessary to go to the main term referenced with the "see" note to locate the correct code. Begin the process by looking for the main term in the alphabetic index. 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. 7 th Characters Certain ICD-10-CM categories have applicable 7 th characters. - Condition listed as the main term, usually a noun. They are placed directly after the code category in the Tabular section of the coding book. False. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principal diagnosis coeds. a. chapter b. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Z63. followed by a list of codes and descriptions. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1 Other reaction to spinal and lumbar puncture Other reaction to spinal dural puncture The Instructional Note under code U07. 1, Alzheimer's disease with late onset, and F02. B. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. The underlying disease must be first sequenced, accompanied by the manifestation, according to the ICD-10-CM coding rule. 6 %âãÏÓ 72708 0 obj > endobj 72713 0 obj >/Filter/FlateDecode/ID[1436CD2AA15C98D34D807083E14FC741>]/Index[72708 14]/Info 72707 0 R/Length 49/Prev 4862096. Some payers are denying claims when heart failure or sepsis codes are sequenced as the principal diagnosis because they are misinterpreting the “code first” note at categories I50, Heart failure, and A41, Other sepsis. The CPT Codes reported were: 68810-50, 68720-50 1. Indicates that is a. A. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM) 2017. In most cases the manifestation codes will have in the code title, "in diseases. ;. University Hospital ICD-10-CM Coding Job Aid Template Part 1: The ICD-10-CM Code Book Part 2: Instructional Notes Instructional Note Type Description Example See also Defines or give examples of the code or category See also neoplasm, by site, benign Code first The ICD-10-CM coding convention requires the underlying condition be sequenced first. ICD-10-CM Quiz 1. the casual condition to be sequenced first if present: in diseases classified elsewhere: indicates that the manifestation codes are component of the etiology/manifestation coding convention: use additional code: etiology and manifestation combination of codes exists the tabular list etiology code containes: excludes1 note290. These notes are provided to assist the. 32601, 32604, 32658, 32659, 32661 33015 33010, 33011 33016 Q22) Repair (Closure) may be classified as: Hint: locate the instructional notes before CPT 12001. appearing. Explain in a few sentences the impact of reporting the code(s) incorrectly. Question options: oth the Index and Tabular the Index the Tabular List ICD-10-CM coding Nonessential modifiers appear in the Alphabetical Index:. Step 2. 7. . The additions for FY 2021 presently pushing the number of codes to over 70,000. ICD-10-CM Code. To select a code in the classification that corresponds to a diagnosis or reason for visit documented in the medical record, first locate the term in the Tabular List. These conventions are incorporated within the Alphabetic Index and Tabular List of the ICD-10-CM as instructional notes. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1. F02. ) Courtesy of the Centers for Medicare & Medicaid Services, 3-1d See Also Instructional Note Another cross-reference note used in ICD-10-CM, the See Also note refers the coder to another location in the Alphabetic Index when the initial listing does not contain all the necessary information to. An excludes2 note The "CODE FIRST" instructional note _____. a. "traffic signs" to guide coders: instructional notes, punctuation marks, abbreviations, and symbols. CPC Prep Course Chapter 3 Notes. 5), indicating that the diagnosis psychogenic vaginismus is not reported. 1 Other reaction to spinal and lumbar puncture Other reaction to spinal dural punctureWherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. Using the ICD-10-CM Alphabetic Index identify the main term (below) that has an instructional note indicating another main term may also be referenced that may provide additional. E. subcategory. algebra2. The first diagnosis listed for inpatient claims as the principal. The Code First approach is a popular way of building applications in the Microsoft . - Determine whether an additional character must be added. There is an instructional note stating to code first underlying disease. Locate the main term in the alphabetic index. The name of a disease, organ, procedure, or body function that is derived from the name of a person, usually a physician or scientist who first identified the condition or devised the object being the name. Question options: is used in both the Index and Tabular is used in the Index is used in the Tabular List is not used in ICD-10-CM coding Nonessential modifiers appear in the Alphabetical Index: Question options: within brackets [ ] within parentheses ( ) following a colon : following a comma ,. The Code First Instructional Note provides a set of guidelines for developers who want to use this approach. A patient is admitted to the hospital with pneumonia. True. “See” and “See Also” –The “see” instruction following a main term in theinstructs that two codes may be required to fully describe the condition, but this note does not provide sequencing direction. The "Code first underlying disease" instructional note found under certain codes is a sequencing rule. The 2 nd note instructs to “ code also ” any associated : open wound. or an instructional note in the Tabular List. 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. Is used to define, give examples, or both, of the content of the category of ICD 10 CM or of a block of category codes. If a causal condition is known, for example, an enlarged prostate, then the code for the enlarged prostate. Read and be guided by instructional notations that appear in. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . Below are just some of the ICD-10-CM guidelines I use and reference on a regular basis: Guideline Section IA:13 – Etiology/Manifestation Convention – Code first and Use additional code notes are sequencing rules in the classification of certain codes that are not part of an. Two codes are provided: C95. o The underlying condition is sequenced first, Diabetes. Verify code in Tabular: S62 Fracture at wrist and hand level . (Multiple Choice) Question 10 . 83-G97. ( opens in new tab/window) Once the package has been installed, edit the manuscript file ecrc-template. Refer to the ICD-10-CM Official Guidelines for Coding and Reporting, section I. INSTRUCTIONAL NOTES Excludes1&2 Tip: Excludes1: Only 1 code can be used Excludes2: 2 codes can be use if both are appropriate and there is proper documentation for both 11/19/2015 17 INSTRUCTIONAL NOTES • “Code First” & “Use Additional Code” • Used for Sequencing Priority – Found in Tabular What is the intent of the instructional note that appears under the category heading for S04? The “code first” note instructs the coder that the selection of side should be based on the side of the body being affected Codes first any associated intracranial injury. About us. The Alphabetic Index does not always provide the full code. xxxx Type 1 diabetes mellitusAnswer: The Use Additional Code note instructs the coder to use an additional code to identify the manifestation that is present. [Brackets] are an ICD-10-CM convention indicating the enclosed code is. True. Identify the instructional note or coding guideline that applies and explain why the code(s) should or should not be reported as listed (3 points) 3. C) appears in the Tabular. These instructional notes indicate the proper sequencing order of the codes, etiology flowed by manifestation if applicable The code-first approach can be time-consuming and expensive. Added instructional notes and inclusion terms Code Description G97. Use additional code to identify the organism (B95, B96) B. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM) 2017. Study with Quizlet and memorize flashcards containing terms like interpreted as meaning and/or, adverse effect, code first underlying disease and more. Instructional notes in both the Alphabetic Index and the Tabular List of ICD-10-CM provide guidance to coders when selecting. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . s Revised Code Codes that have had a change to their description or validity effective October 1,. 80 Dementia in other diseases classified elsewhere without behavioral disturbancereferenced with the “see” note to locate the correct code. For each item listed, indicate the type of instructional note found Category POO Save bobui05h_ch03. The second code is in a square bracket. HIMT 1400. 9. Identify the tentative code (s) associated with the most appropriate modifying term (s). 9. In the Tabular List at the beginning of Chapter 1, Certain Infectious and Parasitic Diseases (A00-B99) there is a note to use an additional code. Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. true. A. the dehydration is coded first, followed by the code(s) from the malignancy. These notes may be found in both the alphabetic index and the tabular list; typically provide information related to a specific section or subsection. This indicates the sequencing. use additional code for. Instructional notes appear in both the Tabular List and Alphabetic Index of ICD-10-CM. b. Includes note. After identifying the term, note its ICD-10 code. does not have to be followed if the original main term provides the correct code. “Sequela” replaces “late effect” terminology from ICD-9. What is the purpose of inclusion notes. There is a "Use Additional Code" notation at the etiology code and a "Code First" note at the manifestation code whenever such a combination exists. A template manuscript file, ecrc-template. determine if the "omit code" instruction applies. Manifestation code = “code 1st” These instructional notes indicate the proper sequencing order of the codes 3. Use additional code, where applicable, to identify: history of tobacco dependence (Z87. ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. 5 points The instructions and conventions of the classification take precedence over _____. xxx Diabetes mellitus due to underlying condition Include the underlying condition diagnosis E09. 4. 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. Influenza immunization. FALSE. Study with Quizlet and memorize flashcards containing terms like List the three diagnoses that are included as described by the "inclusion note" for code R56. Best answers. Inclusion and Exclusion. " d. used in the Tabular listing after a term that is modified by one or more terms following the colon. The two codes must appear in the correct order. List the instructional. Excludes 1: atypical face pain due to fever and chills. , ICD-10-CM disease and injury codes describe causes of illnesses or clinical symptoms exhibited by the patient,. There are also instructional notes to use additional code to identify specific organ dysfunction. Code, if applicable, any causal condition first notes indicate that this code maybe assigned as a first -listed diagnosis when the causal condition is? Unknown/Not Applicable. conventions. 01. If there is a “code first” note within the level, the coder should follow this instruction and sequence the underlying etiology alternatively chronic condition first follow by an manifestation as an additional health. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. use additional code for. Verified answer. Refer to the Tabular List and identify the code that contains an instructional note that indicates that two related conditions cannot occur together. True The Coder must follow the See note in the Alphabetic Index to review additional entries in the Index. This is where you may see a “Use additional” note, or a note that states “Code first”. specific illnesses, injuries, eponyms, abbreviations, and other descriptive diagnostic terms. The classification presumes a causal. includes general notes, inclusion and exclusion notes, "code first" notes, "use additional code" notes and "code also" notes. A. The "code first" note is used ________. The code in brackets in the Alphabetic index is always sequenced as the _____ diagnosis. Give an example of a code that contains an instructional note. When coding pressure ulcers, coders should first code which of the following? Any associated gangrene. ' Instructional notes include. (True/False) Question 2 . chapter b. category c. The 2024 ICD-10-CM update includes 395 new, 25 revised, and 13 deleted codes to be used for patient encounters and discharges occurring from October 1, 2023 through September 30, 2024. 0) 15. When the term “and” is used in a statement, it may be interpreted as, “and/or”. 2 indicating what codes should be reported first and what codes should be reported as additional codes. It's in Section I. Exclude 2 means " not included her" the condition excluded is not part of the condition, but the patient may have both conditions at the same time. Make sure you are coding heart failure to the highest level of specificity documented. In the following problem, find polar and Cartesian forms for all three cube roots of the complex number. How to locate entry in Alphabetic Index. 4. When you look up this code in the Tabular List of the ICD-10-CM code book, you’ll find that this category has the instructional note “Use additional code to identify alcohol abuse and dependence. Inclusion notes. A “code also” note is an instruction that two codes may be required to fully describe a condition, but the seque ncing of the two codes depends on the severity of the conditions and the reason for the office visit. • Instructional Notes •“Code First” / “Use additional code” ‐used to indicate underlying conditions & manifestations ‐ indicates proper sequencing •Example: Chapter 10. 5. 5 is a valid billable ICD-10 diagnosis code for Hyperkalemia . 13 (Etiology/Manifestation Convention) "In addition to the notes in the Tabular List, these conditions also have a specific Alphabetic Index entry structure. A "code also" note instructs that two codes may be required to fully describe a condition, but the sequencing of the two codes is discretionary, depending on. Guest Stacey Elliot referred to the Coding Clinic from the third quarter of 2016, which says: “based on the instructional note, the COPD must be sequenced first. 9 [ G63]. I44. code first underlying disease. 3. Verified questions. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . Identify the instructional note or coding guideline that applies and explain why the code(s) should or should not be reported as listed (3 points) 68720 should be listed first as it is the highest procedure code/more complex procedure. Exclusion Notes. If there is a “code first” note is the tabular, the coder must follow this statement and ordered the underlying etiology or chronic condition beginning tracked by the modifier as an additional diagnosis. • Use additional code: According to an ICD-9-CM coding convention, an underlying condition must be sequenced first, followed by the manifestation. These items provide guidelines for using the code set. notes appearing in the Tabular section or ICD-10-CM and identifying for the coder the sequence of the code assignment.