1. True The "Excludes 1" note _____. None of the provided codes (C30. These instructions signal the coder that an additional code should be reported to provide a more complete picture of that diagnosis. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9-CM. This notation indicates that use of an additional. Make sure to review pairs of ‘Use additional code’ notes at the etiology code, and ‘Code first’ notes at the manifestation code to ensure proper sequencing order in the guidance,” Blanchard adds. Breakdown the ICD-10-CM Guidelines. 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 . Selected Answer: is not used in ICD coding. The principal diagnosis for this case is reported with code _____. 1 indicates if the documentation does not have a causal relationship between the hypertension and heart disease the conditions are coded separately. ICD-10-CM guideline, I. 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 note “Use additional code” (B95–B97) is found in the Tabular List of ICD- 10-CM under Code N39. locate main term in index. Without further description you are directed to R53. The instructional notation that appears for the code for a drug induced fever is ________ . R14. and more. 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. 15. These instructional notes indicate the proper. ↓ See below for any exclusions, inclusions or special notations. 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. C. ) 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. 10. Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA). 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. 8. b. The code for alcohol dependence is located by indexing the main term "Alcoholism". The instructional notes include terms and diagnoses included and excluded for each 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. On the etiology side, the etiology/manifestation combination is signaled by the instructional note “use additional code,” present at the level of the category. At the beginning of Chapter 10, Diseases of the Respiratory System (J00-J99) there is an instructional note to Use additional code, where applicable, to identify tobacco dependence (F17. The placement of an Includes note signifies the section of the code book that the note. General notes. 89, I51. 9. C. A. CHAPTER NOTES (cont. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. e. Appears in the Official Guidelines at I. true false An additional codes instructional note is listed under code 33881. 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. Study ICD-10-CM Coding chapter 6 flashcards. 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. 44- there is an instructional note that states “use additional code to identify the sepsis. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. In this case the patient has end stage renal disease so N18. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. Pay attention to the instructional notes in the tabular list (see yellow highlighted areas). Answer: The Use Additional Code note instructs the coder to use an additional code to identify the manifestation that is present. 2x-3y=-2 x+y=-6. 891) tobacco dependence (F17. The see also instruction in the ICD-10-CM index follows a subterm and refers the coder to another main term that: a. 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. b. F10. 20. QUESTION 1 4 points Sa In the ICD 10 CM manual which type of instructional note is used in the Tabular List of Diseases to identify a code for a condition that is a manifestation of an underlying disease? O A. The definition can be found under number 12A, pg. About us. 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. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. 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. 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. xxxx Type 1 diabetes mellitus3. 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. – The code for the underlying disease will also have an instructional note in the Tabular List to “use additional code” for the 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. 0. A. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. In ICD coding, the code first is not used. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 22? “Use additional code” to identify stage of chronic kidney disease (N18. 20 is assigned a tthe direction of the "use additional code to identify alcohol use and dependence (F10. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The “Use additional” code. 2 is a valid billable ICD-10 diagnosis code for Pelvic and perineal pain . Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. Use additional Characters (red. When a code does not exist that accurately describes the procedure/treatement, the coder should report an unlisted code. – The manifestation codes usually have the phrase “ in diseases classified elsewhere” as part of the code title. 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. 0) is reported as the PDX followed by the code for the heart failure (I50. There is no mention of vomiting. 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 etiology/manifestation combination. Pseudocyst of pancreas Billable Code. ICD-10-CM guideline I. The use additional note may need revision to identify the “type” of sepsis (as is seen in the note. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 322, Carrier or suspected carrier of Methicillin-resistant Staphylococcus aureus, and a code for the MRSA infection may both be assigned. 10. The “code first” note appears in the Tabular List under the. Also indicates the etiology code is to be first listed before the manifestation code. The additional code referenced with the “see” note to locate the correct code. ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. About Quizlet; How Quizlet works; Careers; Advertise with us; Get the app; For students. 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. Correctly use instructional terms and symbols as defined in the ICD-9-CM. Codes with this phrase are never used as a first-listed or principal diagnosis. In most cases, the manifestation codes will have in the code title “in. -)R45. According to the instructional notes for the category code, are the codes for use on the maternal or fetal record, or both? Maternal. that it is a pure excludes note. The 7 th character must always be the 7 th character in the data field. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ICD-10-CM Coding Tips Instructional Notes and Common Coding Mistakes . -). "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. Brackets An instructional note with code N39. The coder must use the main term Infection, bacterial, as cause of disease classified, Klebsiella to locate the additional code of B96. ↓ See below for any exclusions, inclusions or special notations. 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. 30 the correct code. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. 1 should be reported as the principal or first diagnosis, regardless of whether the patient's most recent COVID-19. Use Additional Code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. g. Fully searchable through Find-A-Code's Comprehensive Search. You are directed to R11. 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. CPC Prep Course Chapter 3 Notes. when the note appears under a code, it is acceptable. Instructional notes in the Alphabetic Index and the Tabular List guide coders when selecting ICD-10-CM codes by providing additional instructions. A. The "Excludes 2" note represents all of the following except that _____. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The use of ICD-10 code E86. 0 is a valid billable ICD-10 diagnosis code for Celiac disease . Location. 0 indicates to use additional code to identify the stage of the CKD. 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 . -). 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 using code E66. ↓ See below for any exclusions, inclusions or special notations. This instructional note appears for entities that may develop manifestations, and the. 0. There is an instructional note with I87. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and. " d. true false Appendix C contains coding examples to assist in the selection of. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The "use additional code" note is. In most cases the manifestation codes will have in the code title, "in diseases. Located at the etiology code and directs you to assign a manifestation code. You will also find instructional notes that say code first or use additional code. You should never use the exculde1 code at the same time as the code above Excludes1 notes. The additional code is always listed after the primary code. 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. For such codes, there is a "use additional code" note at the etiology code and a "code first" note at the manifestation code. 4-I51. Appears in the Official Guidelines at I. 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 . 414, Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone. Instructional notes indicate the proper sequencing order of these conditions-etiology (underlying condition) followed by manifestation. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. 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. 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. This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. In the Alphabetic Index, following the main term “sequela,” is the direction term “see also condition” to remind the coder that other entries in the Alphabetic Index are. *Instructional note in ICD-10-CM indicates to use additional code, if applicable, to identify coronary atherosclerosis due to lipid rich plaque (I25. 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. Pelvic and perineal pain Billable Code. A combination code is used to classify? Two diagnosis, a diagnosis w/ an associated secondary process ( manifestation) , a diagnosis w/ an associated complication. This is step number __ when coding: Assign the code to the highest level of specificity. instructional notes, and may also require coding to a higher degree of specificity than indicated here. 4 , N18. General notes. There is a. Expert tip: “Tab your copy of ICD-10 with reminders. 1, C34. Largo, FL. In most cases the manifestation codes will have in the code title, "in diseases. What diagnosis code(s) should be reported for acute and chronic cystitis? a. code first underlying disease. 111. 7, I51. Diseases of the Digestive System. In most cases the manifestation codes will have in the code title, "in diseases. Diseases of the Eye and Adnexa. These items provide guidelines for using the code set. 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. Take note of the tabular instructions for code M31. Combination codes would be reported for these. In most cases the manifestation codes will have in the code title, "in diseases. Use the primary code and change the number of units to match the number of biopsies taken Use the appropriate add-on code for a different technique Use the appropriate add-on code for the appropriate technique Use the primary code and only bill one unitE66. The official AHA publication for ICD-10-CM and ICD-10-PCS coding guidelines and advice. Watch the instructional notes carefully. FIGURE 18-5 Example of. The SEE ALSO instructional note. Explain the use of V and E codes. R14. 5. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1 Code First note 8. 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. 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. Codee F10. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. ) Assign combination codes when available. 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 . E78. 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,. ↓ See below for any exclusions, inclusions or special notations. 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. Graph the system and estimate the solution. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. 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. Basically stated, ICD-10-CM requires you to sequence the underlying condition first “if applicable, followed by the manifestation. When you look up this code in the Tabular List, you’ll find an instructional note to “Code also” adrenal adenoma (D35. ) Assign codes to the highest possible level of detail. c. sometimes used to inform, describe circumstances or give additional information about a term or. 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. infection. When you see a “use additional code” note, followed by a list of codes, in the Alphabetic Index, you know to. What is the correct 7th character for single gestation? 0. In most cases the manifestation codes will have in the code specific eye involved). In most cases, the manifestation codes will have in the code title “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 . Another important instructional note is “Use additional code,” which can lead to querying for clarification of organ dysfunction that may be present, see the. -). additional instruction. N30. "See" and "See Also": The "see" instruction following a main term in the Alphabetic Index shows that. 40 is a valid billable ICD-10 diagnosis code for Major depressive disorder, recurrent, in remission, unspecified . 2. A use additional code note is present at category D70 which instructs to “Use additional code for any associated: fever (R50. Instructional notes appear in both the Tabular List and Alphabetic Index of ICD-10-CM. There is an instructional note to code also the type of asthma, if applicable (J45. With: The words "with" or "in" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, either under a main term or subterm, or an instructional note in the Tabular List. These instructions signal the coder that an additional code should be reported to provide a more complete picture of that diagnosis. -) Use additional code to identify stage of chronic kidney disease ( N18. Z71. instructional notes. are designated in the ICD-10-CM index by brackets. E26. ICD-10-CM;• Read full code descriptors and instructional notes • see, see also, see category • with or without. 22, Type 1 diabetes mellitus with diabetic chronic kidney disease. In most cases the manifestation codes will have in the code title, "in diseases. A. 12. 9 is a valid billable ICD-10 diagnosis code for Acute upper respiratory infection, unspecified . instructional notes. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. ” 1. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In the Alphabetic Index both conditions are listed together with the etiology code first followed by the manifestation codes in brackets. In most cases the manifestation codes will have in the code title, "in diseases. 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. 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. c. This indicates the sequencing. Wherever an etiology and manifestation combination of codes exists, the manifestation code contains an instructional note to: use of an additional code. The underlying disease must be first sequenced, accompanied by the manifestation, according to the ICD-10-CM coding rule. 10. 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 there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. Patient present with anemia and is admitted for transfusion. There is an instructional note that states to "Use additional code to identify the stage of chronic kidney disease (N18. Patient has type 2 DM with diabetes-related CKD stage 3. "Code first". Z98. Question 1. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. followed by the manifestation. What is the instruction provided in the note below code E10. In most cases the manifestation codes will have in the code title, "in diseases. Most notable was the escalation of available diagnosis codes from 14,000 to 68,000 when ICD-10-CM was first initiated in 2015 (CMS, 2015). 0. Etiology or the first disease must be coded first. If this is not the case and coder feels more detail is needed - ask supervisior) 5 very basic (beginning. " In the "Index to Diseases," the multiple coding requirement is indicated by the use of the slanted brackets. the note represents "not included here. In the Tabular List, an instructional note may appear under these category codes to “code first condition resulting from (sequela of)” that particular category. assign an additional code only if the “additional” condition is documented in the health record as being present. The patient is alcohol dependent. 673 is a valid billable ICD-10 diagnosis code for Pain in unspecified foot . CODING CONVENTIONS. the code does not contain additional characters. When there is a "code first" note and an underlying. Coders will see the same “code first” instruction when looking at malignant ascites. 8x has a “use additional code to identify delirium and dementia w/with behavioral disturbance at the beginning of the G30/Alzheimer’s disease section. Z98. 9 (sepsis, unspecified organism) with T81. There is no information of the infectious agent and no additional code is reported. c. First notes indicate that this code may be assigned as first-listed diagnosis when the casual condition is? Un known/ Not Applicable. These conventions are. must be sequenced second as the underlying condition code. (Schraffenberger, 2018, 439)referenced with the “see” note to locate the correct code. d. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. Two “use additional code” notes appear to remind the coder to use an additional code to identify the infectious agent. Instructional notes indicate the proper sequencing order of these conditions-etiology (underlying condition) followed by manifestation. 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 Note under code U07. 2). 22 ? Type 1 diabetes mellitus with chronic kidney disease due to conditions. Multiple codes are required when two codes, the second in brackets and italics, appear after a main term. This note signals that an additional code is necessary to fully. Index of Diseases and Injury. 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. C. = cause of disease. Check the solution algebraically . 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. 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. provide general information on usage in a specific section. true false Modifiers are used to identify when no procedure is done. Preview Terms in this set (21) T/F - The abbreviation of NEC is only used in the Index. 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. The ICD-10-CM Index does have instructional notes to code first the underlying infection. , The instructional note "INCLUDES" ________. 44 (Sepsis following a procedure). if instructional phrase or condition is found after main term or anatomical site has been mistakenly referenced instead of disorder or disease documented in diagnostic statement. 1 directs to use an additional code to identify pneumonia or other manifestations. Some categories of codes (e. 22) history of tobacco use (Z87. exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the. ↓ See below for any exclusions, inclusions or special notations. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 3 is a valid billable ICD-10 diagnosis code for Dietary counseling and surveillance . Use additional code, where applicable, to identify: history of tobacco dependence (Z87. ICD-10-CM;The "See Also" instructional note is a coding guideline that refers the coder to another code or group of codes in the Tabular List of the International Classification of Diseases (ICD). Explain two (2) methods you will use to build good coding habits. The underlying disease must be first sequenced, accompanied by the manifestation, according to the ICD-10-CM coding rule. Use additional code. Chronic kidney disease, stage 3b Billable 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. 82) exposure to environmental tobacco smoke (Z77. The Includes note is used to define, give examples, or both, of the content of a category. 9. but provide additional instruction. Study with Quizlet and memorize flashcards containing terms like combination codes for. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1. “Code first” and “Use additional code” notes are also used in. “See” and “See Also” –The “see” instruction following a main term in theCategory I10-I16 has an instructional note to use an additional code to identify tobacco exposure. 0) 11The “code first” note is your hint that two codes may be needed, along with sequencing direction. Select one: a. defines and or gives examples of the content of a particular category. For instance, if a patient has a diabetes, the coder may use the code E11. N52. 31) •Tobacco dependence (F17. F33. R11. This would code: Fibrillation > atrial > postoperative complication > paroxysmal. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the. Most notable was the escalation of available diagnosis codes from 14,000 to 68,000 when ICD-10-CM was first initiated in 2015 (CMS, 2015). False T/F - NEC means not elsewhere coded. 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 any associated physical or developmental disorders. Therefore, when a patient presents with an acute manifestation of COVID-19, such as pneumonia, code U07. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. The other instructional note is under category code I85 which says to use an additional code to report alcohol abuse and dependence. Often, instructions appear in one place, but aren’t repeated by each code,” said. Whenever 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. 22)” applies to All codes in ICD-10-CM Chapter 10. NEC means not elsewhere classifiable 2. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. false. 9, C37) explicitly indicate the use of additional codes to identify exposures and histories. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. If a code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.