These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. A 3-year-old patient was brought in to the physician's office by her mother because of fever, fussiness, and tugging at the right ear. 9) Under the Category I50 in the ICD-10-CM. J96. d. 2. It instructs you to code first underlying disease, which in this case, is the cirrhosis of the liver from the alcohol. 10. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. Use Additional Code: Note at the etiology code to alert the coder that a manifestation code is needed. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The "Use additional code" _____. 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. 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. True Which of the following is a valid ICD-10-CM code from the Tabular List of Diseases and Injuries? “Code first” notes are under certain codes that are not specifically manifestation codes but may be due to an underlying cause. F40. This notation indicates that use of an additional code. ” The draft guidelines for ICD-10-CM do not require the additional code for this condition, but may require it when final guidelines are implemented. –In the index both conditions are listed together with the. True. 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 . 20 b. In most cases the manifestation codes will have in the code title, "in diseases. 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. More Coding Conventions. The patient is alcohol dependent. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ) Only use NEC/NOS codes when no further detail is possible. The 7th character must always be the 7th character in the data field. 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 . None of the provided codes (C30. 102. The instructional notation that appears for the code for a drug induced fever is ________ . Square brackets are used: In the Alphabetic Index to enclose the manifestation of a disease. 1 states to not assign codes from category Z34 with Chapter 15 codes. E26. urinary tract infectious organism of Klebsiella identified, the coder must follow the instructional note under N39. 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. There is no information of the infectious agent and no additional code is reported. “Code first” and “Use additional code” notes are also used in. antonyms of code titles or "unspecified" terms. but provide additional instruction. use additional code for any associated physical or developmental disorders. What is the ICD-10-CM code for nausea? R11. ” These scenarios can be confusing. R91. When a coder encounters a "Use additional code" note, the coder should NOT assign a code from the list unless it is documented in the record. 9. 0-). The "use additional code" note is. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. In most cases the manifestation codes will have in the code title, "in diseases. Code First :In this scenario the patient has a history of alcohol use making K70. 44- there is an instructional note that states “use additional code to identify the sepsis. The EXCLUDES 2 note represents all of the following except _____. 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. 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 first. 7 th Characters Certain ICD-10-CM categories have applicable 7 th characters. In most cases the manifestation codes will have in the code title, "in diseases. You must use the applicable 7th character for all ICD-10-CM codes within the category or as notes in the Tabular List instruct. 1 directs to use an additional code to identify pneumonia or other manifestations. %PDF-1. For such codes, there is a "use additional code" note at the etiology code and a "code first" note at the manifestation code. 32 is a valid billable ICD-10 diagnosis code for Chronic kidney disease, stage 3b . 00 is found in the ICD-10-CM chapter entitled _____. -). Without further description you are directed to R53. Appear in both the tabular list and alphabetic index of ICD-10-CM. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. False T/F - NEC means not elsewhere coded. The “Use additional” code. Manifestation. R29. 3) Rationale: A note under the code for type 2 DM with diabetic CKD instructs to use an additional code to identify the stage of CKD (N18. In the tabular list, code first and use additional code instructional notes indicate the proper sequencing order of what conditions Certain conditions that have both an underlying etiology and multiple body system manifestations due to the underlying etiology instructional notes indicate a proper sequencing order of these conditions etiology. Notes provide information on code selection. Give an example of a code that contains an instructional note. Expert tip: “Tab your copy of ICD-10 with reminders. Instructional notes include. 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 manifestation codes usually have the phrase “ in diseases classified elsewhere” as part of the code title. 0 (paroxysmal atrial fibrillation) based on the instructional note to use an additional code to specify the. a. 15. The anemia is documented to be due to end stage renal disease (ESRD) after workup. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 12. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ICD-10-CM Official Guidelines for Coding and Reporting FY 2024 Page 8 of 120 5. It is necessary to go to the main term referenced with the "see" note to locate the correct code. contain a use additional code instruction in the ICD-10-CM tabular list. 4. The placement of an Includes note signifies the section of the code book that the note. ICD-10-CM;The instructional note: Use additional code (B95–B97) to identify infectious agent appears under several codes in the tabular. 1. By understanding how to use instructional notes, coders can ensure that they select the correct codes for a. Use additional code. 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. 890 is exempt from POA reporting ( Present On Admission). F33. Korsakoff's (Wernicke) disease, psychosis or. b. All codes in ICD-10-CM Chapter 10. Z98. 7. 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 . ” Per the coding guidelines, this instructional note is found in the Tabular List with codes that are not part of an etiology/manifestation pair where a secondary code is useful to fully describe a condition. "Code first underlying condition" note OC. If this is not the case and coder feels more detail is needed - ask supervisior) 5 very basic (beginning. F10. 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 . Code first any follow-up examination after treatment of malignant neoplasm (Z08). In this example, assigning. Wherever such a combination exists, a Use additional code note is found with the etiology code, and a Code first note is found with the manifestation code. 011, Postthrombotic syndrome with ulcer of right lower extremity, and L97. e. the etiology/ manifestation guideline B. * Because in ICD-10-CM coding coder first assi. ↓ See below for any exclusions, inclusions or special notations. #1. There is no mention of vomiting. After work-up it was determined that he has a benign neoplasm of the temporal lobe of his brain. 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 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ICD-10-CM;• Read full code descriptors and instructional notes • see, see also, see category • with or without. 89, I51. When there is a “code first” note and an underlying condition is present, the underlying condition is sequenced first. 8. 11, there is a “Code first” instruction for complications of bone marrow transplant and stem cell transplant complication. When you look up this code in the Tabular List, you’ll find an instructional note to “Code also” adrenal adenoma (D35. 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. 22) •History of tobacco use (Z87. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a morbidity classification published by the Centers for Medicare and Medicaid Services. algebra2. 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. 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 . Codes with this phrase are never used as a first-listed or principal diagnosis. N30. ICD-10-CM Code. 673 is a valid billable ICD-10 diagnosis code for Pain in unspecified foot . instructs the coder to use an additional code to identify the manifestation that is present. ↓ See below for any exclusions, inclusions or special notations. 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 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The other instructional note is under category code I85 which says to use an additional code to report alcohol abuse and dependence. “Code first” and “Use additional code” notes are also used as sequencing rules in the classification for certain codes that are not part of an etiology/manifestation. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 22, Type 1 diabetes mellitus with diabetic chronic kidney disease. code set based on a system maintained by the World Health Organization. These instructional notes indicate the proper sequencing order of the codes (etiology followed by manifestation). These instructional note indicate the proper sequencing order of the codes, etiology followed by manifestation, if applicable Underlying condition. Adherence to these guidelines when assigning -10-CM ICD diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). In most cases the manifestation codes will have in the code title, 'in diseases. infection. -underlying condition should be sequenced first. 5. ICD-9-CM Conventions NOS . code first any associated physical or developmental disorders. Appears in the Official Guidelines at I. In most cases the manifestation codes will have in the code title, "in diseases. First notes indicate that this code may be assigned as first-listed diagnosis when the casual condition is? Un known/ Not Applicable. Instructional notes Punctuation marks Abbreviations Symbols. The two codes are to be sequenced as listed in the "Index to Diseases. A. Table of Drugs and Chemicals. 850. conventions. 0 says to use additional code (B95-B97), to identify infectious agent. 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 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 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 . Patient present with anemia and is admitted for transfusion. Largo, FL. Preview Terms in this set (21) T/F - The abbreviation of NEC is only used in the Index. 1 - N18. These instructions signal the coder that an additional code should be reported to provide a more complete picture of that diagnosis. J30. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 30. What is the correct 7th character for single gestation? 0. In most cases the manifestation codes will have in the code title, "in diseases. 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 . Learn Test Match Q-Chat Created by chubut Chapter 3 Terms in this set (20) Conventions include: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks,. N52. ) Assign combination codes when available. Whenever such a combination exists, there is a use an additional code note at the etiology code, and a code first note at the manifestation code. View all the articles associated with any code, right from the code page! Study with Quizlet and memorize flashcards containing terms like Four types of conventions: instructional notes, punctuation marks, abbreviations, symbols. 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. 9 ) In the example, we see three distinct conditions listed individually in the Assessment and Plan that are all represented in one combination code. Question: The Code First note instructs the coder to select a code to represent the etiology that caused the manifestation. Chronic sinusitis (includes abscess, empyema, infection, suppuration) There are several instructional notes you must consider when applying the sinusitis codes. True. The use additional note may need revision to identify the “type” of sepsis (as is seen in the note. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Instructional notes, punctuation marks, abbreviations, and symbols. -)" instructional note under category K70. *Instructional note in ICD-10-CM indicates to use additional code, if applicable, to identify coronary atherosclerosis due to lipid rich plaque (I25. 9 (Diabetes mellitus type 2 without complications) to code this diagnosis. 4 , N18. Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Verify code selection in the Tabular List. 6. 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. general notes, inclusion and exclusion notes, code first notes, use additional code notes, and code also notes. It instructs you to code first underlying disease, which in this case, is the cirrhosis of the liver from the alcohol. See cross-references lead the coder to another main term; see also suggest additional possible key terms. Chapter 3: (PASSWORD: NOS) ICD-10-CM Coding Conventions Coding conventions are instructional notes, punctuation marks, abbreviations, and symbols that are used throughout ICD-10-CM and ICD-10-PCS to provide direction when selecting codes. A postcoordination instructional note labeled “Has manifestation (use additional code, if desired)” is a reminder to the user that, depending on the case being coded, it is allowable to post-coordinate any manifestations with the underlying condition. 4-)Study with Quizlet and memorize flashcards containing terms like These _____ are incorporated within the Alphabetic Index and Tabular List of the ICD--CM as instructional notes, The conventions and instructions of the classification take precedence over _____, The _____ _____ is an alphabetical list of terms and their corresponding code. Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. The definition can be found under number 12A, pg. E78. At the beginning of Chapter 15 there is a note to use an additional code from Category Z3A Weeks of gestation, to identify the weeks of gestation for codes O00-O9A. Look for Cirrhosis/liver/alcoholic and you are directed to K70. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. note is not actually needed under the proposed new code at all, since there is already an instructional note regarding the use of additional codes for associated mani festations at the category level, and additional instructional notes are not generally included under existing syndrome codes in this category. 9 in processing claims, check the following: — See additional coding rules. Added instructional notes and inclusion terms Code Description G97. Z71. infection. R10. are designated in the ICD-10-CM index by brackets. Often, instructions appear in one place, but aren’t repeated by each code,” said. A postcoordination instructional note labeled “Has manifestation (use additional code, if desired)” is a reminder to the user that, depending on the case being coded, it is allowable to post-coordinate any manifestations with the underlying condition. 3. Check the solution algebraically . In most cases the manifestation codes will have in the code specific eye involved). Select one: a. Examples of these notes include: Use additional code to identify the infectious agent; Use additional code to identify the virus; Code first any associated lung abscess Code First/Use additional code These instructional notes provide sequencing instruction. ( True/False) Question. In most cases the manifestation codes will have in the code title, "in diseases. E11. When you see a “use additional code” note, followed by a list of codes, in the Alphabetic Index, you know to. In most cases the manifestation codes will have in the code title, "in diseases. F33. N30. 23 is a valid billable ICD-10 diagnosis code for Adjustment disorder with mixed anxiety and depressed mood . 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 . Inclusion notes. 5, N18. the mainifestaion code will have a "code first" instructional note, and the eitiology code will have a " use additonal code" note in the tabular list. Example: E10. 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. 1. These instructional notes indicate the proper sequencing order of the codes, etiology flowed by. ”. When there is a "Code first" note and an underlying condition is present the:-instructional note (Code first) should be followed. The principal diagnosis for this case is reported with code _____. Pelvic and perineal pain Billable Code. 110, ASHD, native artery with unstable angina is a ______ code. Table of Neoplasms. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. followed by the manifestation. and more. 89 is a valid billable ICD-10 diagnosis code for Other specified diseases of anus and rectum . The instructional note found under L58, Radiodermatitis, instructs coders to use an additional code to identify the: source of the radiation. includes general notes, inclusion and exclusion notes, "code first" notes, "use additional code" notes and "code also" notes. are introduced by the word "includes" when placed at the beginning of a chapter or section. ↓ See below for any exclusions, inclusions or special notations. Instructional notes include. 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 . Brackets An instructional note with code N39. 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 . 5. 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 . In most cases the manifestation codes will have in the code title, "in diseases. 1 should be reported as the principal or first diagnosis, regardless of whether the patient's most recent COVID-19. Category J05 Use Additional code note and Code Also 9. The “code first” note appears in the Tabular List under the. A. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and. false. C. Standard Coding Process (4)A benign neoplasm is a (n): H66. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. instructional notes, and may also require coding to a higher degree of specificity than indicated here. ) 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. 1 is a valid billable ICD-10 diagnosis code for Postlaminectomy syndrome, not elsewhere classified . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Introduction ICD-10 was endorsed by the 43rd World Health Assembly in May 1990 and came into use in WHO Member States in 1994 (including US) The classification is the latest in a series, which has its origins in the 1850s The first edition, known as the International List of Causes of. R91. assign an additional code only if the “additional” condition is documented in the health record as being present. Adherence to these guidelines when assigning -10-CM ICD diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. underlying disease, such as: amyloidosis E85Question options: 1 / 1 point What additional code(s) are we advised to use?. There is an instructional note use additional code to identify organism. 7th Character Certain ICD-10-CM categories have applicable 7th characters. However, if the coder also sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List, the coder would then also provide an additional code to provide. . You will also find instructional notes that say code first or use additional code. 6 exists, there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code. g. 13. 22)” applies to. There are several organ dysfunctions listed it the ICD-10-CM Index, but this list is not an exhaustive. There is an instructional note with I87. The etiology code will have a “use additional code” note The manifestation code will have a “code first” note In most cases, “in disease classified elsewhere” will be in the code manifestation title The code title indicates a manifestation code “In diseases classified elsewhere” codes are not to be used as first-listed or. Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA). xxxx Drug or chemical-induced diabetes mellitus Code first a dx from (T36-T65) Use additional code for adverse effect (T36-T50) E10. The Instructional Note under code U07. usually contains a fourth and/or fifth character of 8 and/or 9. 0) 11 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. Used to signify that the conditions listed are not assigned to the category or block of category. Which of the following is a valid ICD-10-CM code from the Tabular List of Diseases and Injuries?The “use additional code” note appears at the etiology and a “code first” note at the manifestation code. " ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. 5 is a valid billable ICD-10 diagnosis code for Hyperlipidemia, unspecified . Coding Guidelines and Instructional Notes for ICD-10-CM Chapter 1 0 Instructional note appears at beginning of chapter, "when a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site" Use additional codes, where applicable, to identify o Exposure. Wherever such a combination exists, a Use additional code note is found with the etiology code, and a Code first note is found with the manifestation code. There are times when a single condition may require multiple coding. , The "See Also" instructional note refers the coder to another location in the Tabular List. A “code also” note is an instruction that two codes may be required to. A) Use "additional code" note. but provide additional instruction. 0) CONVENTIONS 12 • Instructional Notes •“Code also” ‐alerts coder that more than one code may be required to describe the condition ‐does not provide sequencing directionsmanifestation. ICD-10-CM guideline I. 0 can also apply to. , specific ear diseases) may be more extensive, contain additional. The instructional note “Use additional code” (B95–B97) is found in the Tabular List of ICD- 10-CM under Code N39. In most cases the manifestation codes will have in the code title, "in diseases. 2. 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. In most cases the manifestation codes will have in the code title, "in diseases. If a coder sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List it is indicating to the coder the following instruction: Q&A. Hypertension With Heart Disease. true false Modifiers are used to identify when no procedure is done. , Modifiers are used to identify when no procedure is done. precalculus. 0) is reported as the PDX followed by the code for the heart failure (I50. E10. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. (See Appendix A, Section I. Multiple codes are required when two codes, the second in brackets and italics, appear after a main term. 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 . 6). ↓ See below for any exclusions, inclusions or special notations. In the Tabular List, the 6th character 2 is selected to specify the left ovary. These instructional notes indicate the proper. a list of abbreviations, punctuation, symbols, typefaces and instructional notes appearing int he beginning of ICD-9. Possible conventions to include with codes include the following: Notes: Extra information to define or clarify code choice. As with all DM categories, an Excludes 1 note excludes all other DM, including gestational, neonatal, and postprocedural. 5. Otoscopy confirmed acute infection of the canal, with erythema and pus in the canal noted on exam. 414, Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone. use additional code for any associated physical or developmental disorders. Code N18. b. 6 %âãÏÓ 72708 0 obj > endobj 72713 0 obj >/Filter/FlateDecode/ID[1436CD2AA15C98D34D807083E14FC741>]/Index[72708 14]/Info 72707 0 R/Length 49/Prev 4862096. E26. 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. In the Alphabetic Index both conditions are listed together with the etiology code first followed by the manifestation codes in brackets. The use of ICD-10 code E86. The notes also remind the code to use an additional (secondary) code to show the dialysis status (Z99. 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. There is an instructional note to code also the type of asthma, if applicable (J45. -) Use additional code to identify stage of chronic kidney disease ( N18. instructional notes. ↓ See below for any exclusions, inclusions or special notations. Excludes 1: fever and chills. appears in the Tabular NOS means not otherwise specified. Codes First and Use Additional Code Notes Coding convention used in ICD-10-CM that directs the coder as to which condition is coded first is known as a “code first” note. The “use additional code” note appears with the code for toxic shock syndrome because it is an infectious disease code that does not identify the specific bacterial or viral organism that caused it,. When using code n52. Appears in the Official Guidelines at I. Under the Main Term Diabetes in the Index, first-level subterms identify: The specific complication (s) with each type. 8, B96. 9. The instructional notes to code first the underlying physiological condition are found at the category level. “In diseases classified elsewhere“; never permitted to be used as first-listed/principal diagnosis codes; must be used in conjunction with an underlying condition code and must be listed following the underlying condition 4. Indicates that an additional code should be used, if available. 81). These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Excludes1: irradiation cystitis (N30. 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 .